title: Sentinel lymph node biopsy following a rotational flap.
abstract: Sentinel lymph node biopsy (SLNB) is a critical component of melanoma management. Extensive prior surgery at the site of a primary melanoma is considered a relative contraindication for SLNB. While evidence suggests that SLNB may be performed accurately even in those patients who have undergone prior wide local excision, it is less clear whether patients who have undergone more extensive surgical procedures, particularly flap reconstructions, can benefit from this procedure. We report a case of a patient who had undergone surgical removal of a primary melanoma and subsequent reconstruction with a rotational flap in whom a SLNB was performed successfully, which revealed nodal metastasis, suggesting that SLNB may remain an appropriate option in carefully selected patients who have previously undergone extensive surgery at site of primary disease.
authors.affiliation: Duke University School of Medicine, Durham, North Carolina, USA.
authors.forename: Adam K
authors.initials: AK
authors.lastname: Brys
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Schneider
authors.affiliation: Department of Pathology, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: M Angelica
authors.initials: MA
authors.lastname: Selim
authors.affiliation: Department of Surgery, Advanced Oncologic and GI Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mosca
mesh_terms: D000368:Aged; D019468:Disease Management; D018572:Disease-Free Survival; D005260:Female; D006119:Groin; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008223:Lymphoma / Q000175:diagnosis* / Q000601:surgery; D008545:Melanoma / Q000473:pathology* / Q000601:surgery; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000601:surgery; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D013524:Surgical Flaps