Marc Everett1, Haim Gutman. 1. Department of Surgery B, Rabin Medical Center, Beilinson Hospital, Petah Tiqva and Sackler School of Medicine, Tel Aviv University, Israel.
Abstract
BACKGROUND: Metastases of melanoma often follow predictable patterns of lymphatic drainage. However, some cases demonstrate first-echelon drainage to an unexpected basin. We describe a patient with drainage from melanoma on the calf to a sentinel lymph node in the iliac basin. METHODS AND RESULTS: Biopsy of the sentinel lymph node was guided by preoperative lymphoscintigraphy and intraoperative use of a gamma probe and blue dye. The node excised from the iliac basin showed evidence of metastasis. CONCLUSION: The failure to detect aberrant sentinel lymph nodes and bypassed basins may lead to improper assessment of disease stage and deficient patient management.
BACKGROUND:Metastases of melanoma often follow predictable patterns of lymphatic drainage. However, some cases demonstrate first-echelon drainage to an unexpected basin. We describe a patient with drainage from melanoma on the calf to a sentinel lymph node in the iliac basin. METHODS AND RESULTS: Biopsy of the sentinel lymph node was guided by preoperative lymphoscintigraphy and intraoperative use of a gamma probe and blue dye. The node excised from the iliac basin showed evidence of metastasis. CONCLUSION: The failure to detect aberrant sentinel lymph nodes and bypassed basins may lead to improper assessment of disease stage and deficient patient management.