Parotid Selective Lymphadenectomy in Malignant Melanoma

Sentinel Lymph Node Biopsy for Melanoma: How Many Radioactive Nodes Should be Removed?

“…In the present study, 24.3% of patients with melanomas 1.0 mm or more in thickness were found to have histologic evidence of nodal metastasis. This is slightly higher than the rate in many other published series [1][2][3][4][5][6][7][8][9] and indicates that the pathologic methods used are effective at detecting micrometastatic disease.…”

“…It has been demonstrated that the use of the blue dye in combination with the radioactive colloid leads to optimal detection and identification of sentinel nodes for melanoma. [2][3][4][5][6][7][8][9] There is, however, some controversy about the exact definition of a sentinel node. It has been suggested that the blue dye staining of the afferent lymphatic channel leading into the sentinel node is the sine qua non of a true sentinel node, because it indicates a direct lymphatic pathway from the site of the melanoma.…”

“…10,11 It is clear, however, that radioactive colloid injection with gamma probe detection often identifies sentinel nodes that would not have been detected with blue dye alone, and positive sentinel nodes that have no evidence of blue dye staining occasionally are identified. [2][3][4][5][6][7][8][9] Several different definitions of the term sentinel node have been proposed based on the degree of radioactivity within the node. Among these are definitions based on the absolute number of counts in the node, or on the ratio of the in vivo or ex vivo radioactive counts in the node to background radioactivity or to neighboring non-sentinel nodes.…”

Primitive Malignant Melanoma of the Parotid Gland

“…Malignant melanoma of the head and neck can spread to parotid nodes without affecting the gland itself [16].…”

“…Some authors do not recommend routine partial parotidectomy for patients with primitive malignant melanoma of the head and neck, preferring to perform a lymphatic mapping and a lymphadenectomy of the 'sentinel' node [16,20]. Barr et al [21] recommend total parotidectomy with preservation of the facial nerve and radical neck dissection when there are palpable cervical nodes.…”