A case of penile melanoma illustrating the low sensitivity of frozen sections in the assessment of sentinel lymph nodes.
A 75 year-old uncircumcised man presented with a 1.1mm thick malignant melanoma on the ventral aspect of the glans penis. He underwent isosulfan blue and technetium 99m guided sentinel lymph node (SLN) biopsy and distal penectomy with 2 cm margins. This is the third reported case of penile melanoma using both markers for SLN mapping. While frozen sections and H& E stains were negative, S-100 and HMB-45 immunohistochemistry revealed micrometastasis in one of the sentinel nodes. This case illustrates that any discussion with the patient about management and prognosis should await immunohistochemistry results.
D000368:Aged; D001706:Biopsy; D005629:Frozen Sections / Q000379:methods*; D006801:Humans; D007264:Inguinal Canal / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000737:chemistry / Q000473:pathology* / Q000556:secondary* / Q000601:surgery; D010412:Penile Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D012394:Rosaniline Dyes / Q000032:analysis; D012680:Sensitivity and Specificity; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*
D012394:Rosaniline Dyes; C025484:iso-sulfan blue