Micrometastasis to in-transit lymph nodes from extremity and truncal malignant melanoma.
BACKGROUND
The sentinel lymph node (SLN) is the first lymph node in the regional nodal basin to receive metastatic cells. In-transit nodes are found between the primary melanoma site and regional nodal basins. To date, this is one of the first reports on micrometastasis to in-transit nodes.


METHODS
Retrospective database and medical records were reviewed from October 21, 1993, to November 19. 1999. At the UCSF Melanoma Center, patients with tumor thickness > 1 mm or < 1 mm with high-risk features are managed with preoperative lymphoscintigraphy, selective SLN dissection, and wide local excision.


RESULTS
Thirty (5%) out of 557 extremity and truncal melanoma patients had in-transit SLNs. Three patients had positive in-transit SLNs and negative SLNs in the regional nodal basin. Two patients had positive in-transit and regional SLNs. Three patients had negative in-transit SLNs but positive regional SLNs. The remaining 22 patients were negative for in-transit and regional SLNs.


CONCLUSIONS
In-transit SLNs may harbor micrometastasis. About 10% of the time, micrometastasis may involve the in-transit and not the regional SLN. Therefore, both in-transit and regional SLNs should be harvested.
Thelmo
M C
MC
Department of Surgery, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, 94115, USA.
Morita
E T
ET
Treseler
P A
PA
Nguyen
L H
LH
Allen
R E
RE
Sagebiel
R W
RW
Kashani-Sabet
M
M
Leong
S P
SP
D005121:Extremities / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis / Q000473:pathology*; D008545:Melanoma / Q000473:pathology*; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*; D013909:Thorax / Q000473:pathology*