title: Mid-humeral sentinel lymph node dissection in patients with primary cutaneous malignant melanoma.
abstract: In rare cases, lymphatic drainage from the malignant melanomas in the upper extremity may follow an unpredictable pattern (outside the axillary nodes), and these aberrant sentinel nodes may represent the only site of regional lymph node metastases. The precise anatomical landmarks and technical aspects of surgical exploration of these aberrant sentinel lymph nodes are rarely described in the literature, including aberrant sentinel mid-humeral lymph nodes. This report describes a step-by-step dissection of the mid-humeral sentinel lymph nodes in two patients with a primary malignant melanoma in the upper extremity, identified by lymphatic mapping. Recognition of precise regional anatomy and following a special surgical technique makes the procedure safe and successful, thus avoiding local complications and allowing a prompt recovery.
authors.affiliation: General Surgery Department, Division of Clinical Surgery III, Hospital das Clinicas and LIM 62, University of Sao Paulo School of Medicine, Brazil.
authors.forename: Frederico
authors.initials: F
authors.lastname: Teixeira
authors.forename: Eduardo
authors.initials: E
authors.lastname: Akaishi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mendes
authors.forename: Vitor
authors.initials: V
authors.lastname: Moutinho
authors.forename: Edivaldo
authors.initials: E
authors.lastname: Utiyama
authors.forename: Samir
authors.initials: S
authors.lastname: Rasslan
mesh_terms: D005260:Female; D006801:Humans; D006811:Humerus; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D012878:Skin Neoplasms / Q000175:diagnosis / Q000601:surgery*