Original Articles

Annals of Surgical Oncology

, Volume 10, Issue 4, pp 403-407

First online:

Sentinel Lymph Node Biopsy for Patients With Cutaneous Desmoplastic Melanoma

  • David E. GyorkiAffiliated withDepartment of Surgery, Memorial Sloan-Kettering Cancer Center
  • , Klaus BusamAffiliated withDepartment of Surgical Pathology, Memorial Sloan-Kettering Cancer Center
  • , Kathy PanageasAffiliated withDepartment of Biostatistics, Memorial Sloan-Kettering Cancer Center
  • , Mary Sue BradyAffiliated withDepartment of Surgical Pathology, Memorial Sloan-Kettering Cancer Center
  • , Daniel G. CoitAffiliated withDepartment of Surgery, Memorial Sloan-Kettering Cancer CenterGastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center Email author 

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Background: Although desmoplastic melanoma (DM) often presents at a locally advanced stage, nodal metastases are rare. We describe our experience with lymphatic mapping and sentinel lymph node biopsy (SLNB) in patients with DM to characterize the biological behavior of these tumors.

Methods: Twenty-seven patients with cutaneous DM underwent wide excision and attempted SLNB between 1996 and 2001. All pathology was reviewed by a single dermatopathologist (KB). Clinical and histological features were recorded.

Results: There were 20 male and 7 female patients. The median age was 64 years (range, 35–83 years). The head and neck was the most commonly involved anatomical region (n = 14). The median Breslow thickness was 2.2 mm. Twenty-four patients underwent successful SLNB. No patient had a positive sentinel node. At a median follow-up of 27 months, five patients recurred (four systemic and one local); all five had undergone successful SLNB. Two of these patients died of disease, two are alive with disease, and one remains alive and disease free. No patient experienced failure in a regional nodal basin.

Conclusions:DM is a biologically distinct form of melanoma, with a very low incidence of regional lymph node metastases, either at presentation or in long-term follow-up. This biology should be considered when designing rational treatment strategies for these patients.

Key Words:

Desmoplastic melanoma Sentinel lymph node biopsy Local recurrence Survival