title: Micrometastasis to in-transit lymph nodes from extremity and truncal malignant melanoma.
abstract: 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.
authors.affiliation: Department of Surgery, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, 94115, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Thelmo
authors.forename: E T
authors.initials: ET
authors.lastname: Morita
authors.forename: P A
authors.initials: PA
authors.lastname: Treseler
authors.forename: L H
authors.initials: LH
authors.lastname: Nguyen
authors.forename: R E
authors.initials: RE
authors.lastname: Allen
authors.forename: R W
authors.initials: RW
authors.lastname: Sagebiel
authors.forename: M
authors.initials: M
authors.lastname: Kashani-Sabet
authors.forename: S P
authors.initials: SP
authors.lastname: Leong
mesh_terms: 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*