title: Ultrasound diagnosis of an atypical axillary lesion.
abstract: We report on the case of a 41-year-old man with a recently diagnosed amelanotic ulcerated melanoma, with a Breslow thickness of 3.5 mm and Clark level IV. He had a pre-existing mass in the axilla, which had grown in parallel to the developing tumor. A large regional lymph node was clinically suspected. Ultrasound (US) examination of the axilla showed a large benign lipoma but also a very atypical peripheral perfusion. At the same time, a sentinel node showed a peripheral perfusion on US. Fine-needle aspiration cytology was performed of the different lesions and showed a melanoma metastasis in the sentinel node. Thereafter, a lymph node dissection was performed. The lipoma was seen in histopathology and even the peripheral perfusion was confirmed. US and US-guided fine-needle aspiration cytology can be easily applied in the diagnosis of lymph node metastases in melanoma patients and can help determine a benign or a malignant involvement.
authors.affiliation: aDepartment of Dermatology, Charité, Humboldt University of Berlin, Berlin bDepartment of Dermatology, University of Mainz, Mainz, Germany cDepartment of Surgical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands dInstitute Gustave Roussy Cancer Center, Villejuif, Paris Sud, France.
authors.forename: Christiane A
authors.initials: CA
authors.lastname: Voit
authors.forename: Alexander C J
authors.initials: AC
authors.lastname: van Akkooi
authors.forename: Alexander M M
authors.initials: AM
authors.lastname: Eggermont
authors.forename: Andrea
authors.initials: A
authors.lastname: Tüttenberg
mesh_terms: D000328:Adult; D001365:Axilla / Q000473:pathology; D001706:Biopsy / Q000379:methods*; D044963:Biopsy, Fine-Needle / Q000379:methods*; D006801:Humans; D008067:Lipoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000175:diagnosis; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D021701:Sentinel Lymph Node Biopsy / Q000379:methods; D012878:Skin Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000601:surgery*; D014463:Ultrasonography