title: Desmoplastic and neurotropic melanoma.
abstract: BACKGROUND
  Desmoplastic and neurotropic melanoma (DNMM) occasionally metastasizes to regional lymph nodes and extranodal sites. The value of sentinel lymph node biopsy (SLNB) has not been demonstrated clearly for patients with DNMM. The authors report on the utility of SLNB in the management of patients with DNMM.
  
  
  METHODS
  The authors identified 33 patients with DNMM who were seen during a 5-year period in their institution who underwent lymphatic mapping and SLNB. Clinical and histopathologic data were reviewed.
  
  
  RESULTS
  Thirty-three patients with DNMM underwent SLNB (mean Breslow depth, 4.0 mm; median, 2.8 mm). There were 25 male patients and 8 female patients with a median age of 61 years (range, 31-86 years). Fifty-two percent of tumors presented in the head and neck region, and 24% were associated with lentigo maligna. Four of 33 patients (12%) without clinical evidence of metastatic disease who underwent SLNB had at least 1 positive sentinel lymph node. No additional positive lymph nodes were found in subsequent therapeutic regional lymphadenectomy in any of these four patients.
  
  
  CONCLUSIONS
  SLNB detected subclinical metastases of DNMM to regional lymph nodes. SLNB at the time of resection can provide useful information to guide early treatment and, coupled with lymphadenectomy in positive patients, may limit tumor spread and prevent recurrence at the draining lymph node basin.
authors.affiliation: Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan48109-0602, USA. lyndonsu@umich.edu
authors.forename: Lyndon D
authors.initials: LD
authors.lastname: Su
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Fullen
authors.forename: Lori
authors.initials: L
authors.lastname: Lowe
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Wang
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Schwartz
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Cimmino
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D016019:Survival Analysis; D016896:Treatment Outcome