title: Resection in the popliteal fossa for metastatic melanoma.
abstract: BACKGROUND
  Traditionally metastatic melanoma of the distal leg and the foot metastasize to the lymph nodes of the groin. Sometimes the first site of nodal disease can be the popliteal fossa. This is an infrequent event, with rare reports in literature and when it occurs, radical popliteal node dissection must be performed.
  
  
  METHODS
  We report a case of a 36-year old man presented with diagnosis of 2 mm thick, Clark's level II-III, non ulcerated melanoma of the left heel, which developed during the course of the disease popliteal node metastases, after a superficial and deep groin dissection for inguinal node involvement. Five months after popliteal lymph node dissection he developed systemic disease, therefore he received nine cycles of dacarbazine plus fotemustine. To date (56 months after prior surgery and 11 months after chemotherapy) he is alive with no evidence of disease.
  
  
  CONCLUSIONS
  In case of groin metastases from melanoma of distal lower extremities, clinical and ultrasound examination of ipsilateral popliteal fossa is essential. When metastatic disease is found, radical popliteal dissection is the standard of care. Therefore knowledge of anatomy and surgical technique about popliteal lymphadenectomy are required to make preservation of structures that if injured, can produce a permanent, considerable disability.
authors.affiliation: Department of Surgical Oncology B, National Cancer Institute of Naples, Italy. dott.marone@virgilio.it
authors.forename: Ugo
authors.initials: U
authors.lastname: Marone
authors.forename: Corrado
authors.initials: C
authors.lastname: Caracò
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Chiofalo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Botti
authors.forename: Nicola
authors.initials: N
authors.lastname: Mozzillo
mesh_terms: D000328:Adult; D006119:Groin; D006801:Humans; D007717:Knee; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology*