Optimal Selective Sentinel Lymph Node Dissection in Primary Malignant Melanoma

Abstract

Sequential combination of preoperative lymphoscintigraphy and intraoperative mapping is a reliable way to identify regional SLN. The frequency of microscopic metastatic melanoma of the SLN(s) is 18.4%. Gamma-probe--guided resection minimizes the extent of lymph node dissection. Further follow-up is needed to assess the outcome of this group of patients for regional and systemic recurrences.

Discordancy Between Clinical Predictions vs Lymphoscintigraphic and Intraoperative Mapping of Sentinel Lymph Node Drainage of Primary Melanoma

“…The technique has been described in detail previously. 23 Briefly, technetium Tc 99m ( 99m Tc) sulfur colloid filtered through a 22-µm filter was injected intradermally around the primary melanoma or the biopsy site. Immediate dynamic imaging was performed to assess the uptake of radiotracer by the lymphatic channels.…”

Prediction of Sentinel Lymph Node Micrometastasis by Histological Features in Primary Cutaneous Malignant Melanoma

“…Details on the surgical method are described elsewhere. 15 The SLNs were analyzed histologically by means of level sections and hematoxylin-eosin staining. Immunohistochemistry staining for HMB 45 and S-100 was performed if the hematoxylin-eosin preparation was not definitive.…”

Evidence-Based Principles in Pathology: Existing Problem Areas and the Development of “Quality” Practice Patterns

“…4 That credo has led to the procedure known as the ''sentinel lymph node biopsy'' (SLNB). 5,6 Tracer materials are injected into the tissue surrounding a primary tumor, and the lymph node with the highest concentration of the marker is labeled as the first one (the ''sentinel'') through which lymphatic fluid from a tumor site passes. 7 On the basis of that premise, one would conclude that an absence of neoplastic cells in the sentinel lymph node (SLN) should preclude their presence in the ''downstream'' (basin) lymph nodes and the viscera.…”