title: Popliteal lymph node dissection for metastases of cutaneous malignant melanoma.
abstract: Popliteal lymph node dissection is performed when grossly metastatic nodal disease is encountered in the popliteal fossa or after microscopic metastasis is found in interval sentinel nodes during clinical staging of cutaneous malignant melanoma. Initially, an S-shaped incision is made to gain access to the popliteal fossa. A careful en bloc removal of fat tissue and lymph nodes is made to preserve and avoid the injury of peroneal and tibial nerves as well as popliteal vessels, following the previous recommendations. This rare surgical procedure was successfully employed in a patient with cutaneous malignant melanoma and nodal metastases at the popliteal fossa. The technique described by Karakousis was reproduced in a step-by-step fashion to allow anatomical identification of the neurovascular structures and radical resection with no post-operative morbidity and prompt recovery. Popliteal lymph node dissection is a rarely performed operative procedure. Following a lymphoscintigraphic examination of the popliteal nodal station, surgeons can be asked to explore the popliteal fossa. Detailed familiarity of the operative procedure is necessary, however, to avoid complications.
authors.forename: Frederico
authors.initials: F
authors.lastname: Teixeira
authors.affiliation: Department of General Surgery, Surgical Oncology Group, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. vitor.moutinho@hc.fm.usp.br.
authors.forename: Vitor
authors.initials: V
authors.lastname: Moutinho
authors.forename: Eduardo
authors.initials: E
authors.lastname: Akaishi
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mendes
authors.forename: Andre
authors.initials: A
authors.lastname: Perina
authors.forename: Tiberio
authors.initials: T
authors.lastname: Lima
authors.forename: Margareth
authors.initials: M
authors.lastname: Lallee
authors.forename: Sergio
authors.initials: S
authors.lastname: Couto
authors.forename: Edivaldo
authors.initials: E
authors.lastname: Utiyama
authors.forename: Samir
authors.initials: S
authors.lastname: Rasslan
mesh_terms: D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D011150:Popliteal Artery / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012878:Skin Neoplasms / Q000556:secondary / Q000601:surgery*