Epitrochlear lymph nodes as a site of melanoma metastasis

Hunt, Jillian; Thompson, Jim; Uren, RF; Howman-Giles, R; Harman, C R

doi:10.1097/00008390-199706001-00381

Cited by 13 publications

(25 citation statements)

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“…A possible exception to consider is when clinically palpable disease presents in the unusual basin. Hunt et al described 10 patients who had therapeutic epitrocheal lymphadenectomy for clinically evident disease [63]. Six patients underwent simultaneous axillary lymphadenectomy and three of these had occult metastatic melanoma.…”

Section: Unusual Sites Of Metastasesmentioning

confidence: 99%

Controversies in the management of metastatic melanoma to regional lymphatic basins

Mack

McKinnon

2004

Journal of Surgical Oncology

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The primary management of lymph nodes involved with metastatic melanoma is regional lymphadenectomy. Many controversies of regional lymph node dissection exist including extent and nature of the lymphadenectomy, treatment of lymphatic metastases in unusual locations and the role of adjuvant radiotherapy. Although radical neck dissection has been the gold standard for cervical disease, modified dissections do not seem to compromise regional control in appropriately selected patients. In the axilla, a Level I, II, and III dissection is most commonly performed. Combined superficial and deep groin dissection is justified for clinically palpable disease although management of patients with histologically positive yet clinically non-palpable disease is more controversial. Burden of disease, imaging, patient co-morbidity, and Cloquet nodal status must be considered. Many technical variations exist in an attempt to improve morbidity rates secondary to lymphadenectomy. Unfortunately, complication rates are difficult to compare secondary to variable study designs, definitions, and patient populations. Adjuvant radiation therapy appears warranted in patients with high risk of regional recurrence including bulky disease, extracapsular extension or cervical location.

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Section: Unusual Sites Of Metastasesmentioning

confidence: 99%

Controversies in the management of metastatic melanoma to regional lymphatic basins

Mack

McKinnon

2004

Journal of Surgical Oncology

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“…b ''In series'' nodes receive afferent lymphatics from a cutaneous primary and send efferent lymphatics to a sentinel node in the major basin; if the major basin sentinel node is negative, no regional lymphadenectomy would be indicated even if the in transit sentinel node contains tumor. c ''In parallel'' nodes receive afferent lymphatics from a cutaneous primary but send efferent lymphatics to a nonsentinel node in the major basin; if a major basin sentinel node is negative, there would still be a substantial risk of metastatic disease within that major basin and lymphadenectomy would be appropriate to consider frequent in interval and minor basin nodes than major basin nodes, 1,8,9 but the reported rates of tumor involvement are clearly high enough to justify excising and analyzing in transit nodes whenever feasible. Based on available data, a positive interval or minor basin node seems to have essentially the same impact on prognosis as a positive major basin node.…”

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confidence: 99%

What is the Significance of the In Transit or Interval Sentinel Node in Melanoma?

2011

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“…2,3 Hunt et al reported that epitrochlear node metastasis occurred in only 1.1% of upper limb primary melanomas. 4 However, Smith et al reported that the incidence of metastasis in epitrochlear nodes is 18% if primary melanoma is located on the forearm or hand lesions, especially on the ulnar distribution or within 3-5 cm of the elbow. 5 In our patient, primary melanoma was located on the forearm (around the elbow), and epitrochlear node metastasis occurred 2 years after her operation when she was pregnant.…”

Section: Discussionmentioning

confidence: 99%

Case of metastatic melanoma in an epitrochlear lymph node arising in a pregnant woman

Yoshida

Takahashi

Koga

et al. 2006

The Journal of Dermatology

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We describe a rare case of metastatic melanoma in an epitrochlear lymph node in a 29-year-old female patient. The patient had been aware of a brown macule on her right posterior forearm at puberty. Because the lesion had enlarged rapidly, she was referred to our hospital. Histological examination revealed a malignant melanoma. She underwent wide local excision with 3-cm margins and split thickness skin graft closure, but we were not able to perform sentinel node biopsy. She also received three cycles of systemic chemotherapy with dacarbazine, nimustine, vincristine and interferon-beta. However, an epitrochlear node (interval node) metastasis occurred during pregnancy (seventh week) 2 years after the operation. We emphasize that it is important for clinicians to pay attention to the possibility of epitrochlear node metastasis in patients with malignant melanoma in the upper extremity and that it is necessary to perform sentinel node biopsy to identify uncommon lymph node metastasis.

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Epitrochlear lymph nodes as a site of melanoma metastasis

Abstract: Background:The incidence of epitrochlear lymph node metastasis for patients with melanomas

Cited by 13 publications

References 0 publications

Controversies in the management of metastatic melanoma to regional lymphatic basins

Controversies in the management of metastatic melanoma to regional lymphatic basins

What is the Significance of the In Transit or Interval Sentinel Node in Melanoma?

Case of metastatic melanoma in an epitrochlear lymph node arising in a pregnant woman

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