title: Case of metastatic melanoma in an epitrochlear lymph node arising in a pregnant woman.
abstract: We describe a rare case of metastatic melanoma in an epitrochlear lymph node in a 29-year-old female patient. The patient had been aware of a brown macule on her right posterior forearm at puberty. Because the lesion had enlarged rapidly, she was referred to our hospital. Histological examination revealed a malignant melanoma. She underwent wide local excision with 3-cm margins and split thickness skin graft closure, but we were not able to perform sentinel node biopsy. She also received three cycles of systemic chemotherapy with dacarbazine, nimustine, vincristine and interferon-beta. However, an epitrochlear node (interval node) metastasis occurred during pregnancy (seventh week) 2 years after the operation. We emphasize that it is important for clinicians to pay attention to the possibility of epitrochlear node metastasis in patients with malignant melanoma in the upper extremity and that it is necessary to perform sentinel node biopsy to identify uncommon lymph node metastasis.
authors.affiliation: Department of Dermatology, School of Medicine, Fukuoka University, Fukuoka, Japan. yxy@grape.med.tottori-u.ac.jp
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Akira
authors.initials: A
authors.lastname: Takahashi
authors.forename: Monji
authors.initials: M
authors.lastname: Koga
authors.forename: Kaori
authors.initials: K
authors.lastname: Koga
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kubota
authors.forename: Juichiro
authors.initials: J
authors.lastname: Nakayama
mesh_terms: D000328:Adult; D001132:Arm; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008545:Melanoma / Q000556:secondary* / Q000601:surgery; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery