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Micrometastasis to In-Transit Lymph Nodes From Extremity and Truncal Malignant Melanoma

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Abstract

Background: The sentinel lymph node (SLN) is the first lymph node in the regional nodal basin to receive metastatic cells. In-transit nodes are found between the primary melanoma site and regional nodal basins. To date, this is one of the first reports on micrometastasis to in-transit nodes.

Methods: Retrospective database and medical records were reviewed from October 21, 1993, to November 19, 1999. At the UCSF Melanoma Center, patients with tumor thickness >1 mm or <1 mm with high-risk features are managed with preoperative lymphoscintigraphy, selective SLN dissection, and wide local excision.

Results: Thirty (5%) out of 557 extremity and truncal melanoma patients had in-transit SLNs. Three patients had positive in-transit SLNs and negative SLNs in the regional nodal basin. Two patients had positive in-transit and regional SLNs. Three patients had negative in-transit SLNs but positive regional SLNs. The remaining 22 patients were negative for in-transit and regional SLNs.

Conclusions: In-transit SLNs may harbor micrometastasis. About 10% of the time, micrometastasis may involve the in-transit and not the regional SLN. Therefore, both in-transit and regional SLNs should be harvested.

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Authors and Affiliations

  1. Department of Surgery, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California

    Marylou C. Thelmo MD, MPH, Luyen Huu Nguyen BA, Robert E. Allen Jr. MD & Stanley P. L. Leong MD

  2. Department of Nuclear Medicine, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California

    Eugene T. Morita MD

  3. Department of Pathology, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California

    Patrick A. Treseler MD, PhD

  4. Department of Melanoma Center, University of California at San Francisco Medical Center at Mount Zion and UCSF Comprehensive Cancer Center, San Francisco, California

    Richard W. Sagebiel MD & Mohammed Kashani-Sabet MD

  5. Department of Surgery, UCSF Comprehensive Cancer Center, 1600 Divisadero Street, Suite C333, San Francisco, CA, 94115

    Stanley P. L. Leong MD

Authors
  1. Marylou C. Thelmo MD, MPH
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  2. Eugene T. Morita MD
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  3. Patrick A. Treseler MD, PhD
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  4. Luyen Huu Nguyen BA
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  5. Robert E. Allen Jr. MD
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  6. Richard W. Sagebiel MD
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  7. Mohammed Kashani-Sabet MD
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  8. Stanley P. L. Leong MD
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Corresponding author

Correspondence to Stanley P. L. Leong MD.

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Supported in part by a grant from the Eva B. Buck Charitable Trust.

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Thelmo, M.C., Morita, E.T., Treseler, P.A. et al. Micrometastasis to In-Transit Lymph Nodes From Extremity and Truncal Malignant Melanoma. Ann Surg Oncol 8, 444–448 (2001). https://doi.org/10.1007/s10434-001-0444-3

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  • DOI: https://doi.org/10.1007/s10434-001-0444-3

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