February 11, 2009: excision of skin lesion on the back of the torso. -Histology: malignant, epithelioid-cell, non-ulcerated melanoma; Clark’s level IV; Breslow thickness 2.7 mm; mild peritumoral lymphocyte infiltration; resection margins free from neoplastic infiltration.
Teaching points:
Lymphatic mapping and sentinel lymph node biopsy represent a minimally invasive procedure for identifying occult microscopic disease.
The goals of this technique are: 1) regional lymph node staging; 2) regional disease control; 3) potential cure (in patients with stage III disease).
The examination is usefully complemented by a SPECT/CT study, to correctly determine the anatomical location of sentinel lymph node(s) and to precisely identify in-transit or ectopically located sentinel nodes.
