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Epitrochlear node involvement in melanoma of the upper extremity.

T J Smith, G M Sloan, A R Baker

    Cancer
    |February 15, 1983
    PubMed
    Summary

    Melanoma patients with upper extremity lesions have an 18% risk of epitrochlear lymph node metastasis. Early detection and dissection of suspicious epitrochlear nodes improve locoregional control for these melanoma cases.

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    Area of Science:

    • Oncology
    • Dermatology
    • Surgical Oncology

    Background:

    • Melanoma of the upper extremity is relatively uncommon.
    • Understanding lymphatic drainage patterns is crucial for effective treatment and prognosis.

    Observation:

    • A retrospective review of 240 National Institutes of Health (NIH) patients with upper extremity melanoma between 1955 and 1979.
    • 39 patients (16%) had primary lesions on the forearm, hand, or digit.
    • 10 patients underwent both axillary and epitrochlear lymph node dissection, with 9 showing metastases.

    Findings:

    • Epitrochlear lymph node involvement was observed in 18% of patients with forearm/hand melanomas.
    • This involvement was associated with primary lesions near the elbow or in the ulnar distribution.
    • Metastases occurred in axillary nodes only, epitrochlear nodes only, or both.

    Implications:

    • The epitrochlear nodes are a potential site for melanoma metastasis in the upper extremity.
    • Clinically monitoring the epitrochlear region and performing early dissection of suspicious nodes can improve locoregional control.
    • Prognosis is linked to primary lesion depth and axillary node status, but epitrochlear involvement warrants specific attention.

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