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Dermatology Research and Practice
Volume 2011 (2011), Article ID 506790, 3 pages
http://dx.doi.org/10.1155/2011/506790
Research Article

Interval Sentinel Lymph Nodes: An Unusual Localization in Patients with Cutaneous Melanoma

1Department of Dermatology, University Hospital Spedali Civili, 25123 Brescia, Italy
2Department of II Surgery, University Hospital Spedali Civili, 25123 Brescia, Italy
3Department of Nuclear Medicine, University Hospital Spedali Civili, 25123 Brescia, Italy
4Department of I Pathology, University Hospital Spedali Civili, 25123 Brescia, Italy

Received 29 December 2010; Revised 22 February 2011; Accepted 3 March 2011

Academic Editor: Mario Santinami

Copyright © 2011 A. M. Manganoni et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Recent studies have demonstrated that there exists a great variation in the lymphatic drainage in patients with malignant melanoma. Some patients have drainage to lymph nodes outside of conventional nodal basins. The lymph nodes that exist between a primary melanoma and its regional nodal basin are defined “interval nodes”. Interval node occurs in a small minority of patients with forearm melanoma. We report our experience of the Melanoma Unit of University Hospital Spedali Civili Brescia, Italy. Methods. Lymphatic mapping using cutaneous lymphoscintigraphy (LS) has become a standard preoperative diagnostic procedure to locate the sentinel lymph nodes (SLNs) in cutaneous melanoma. We used LS to identify sentinel lymph nodes biopsy (SLNB) in 480 patients. Results. From over 2100 patients affected by cutaneous melanoma, we identified 2 interval nodes in 480 patients with SLNB . The melanomas were both located in the left forearm. The interval nodes were also both located in the left arm. Conclusion. The combination of preoperative LS and intraoperative hand-held gamma detecting probe plays a remarkable role in identifying these uncommon lymph node locations. Knowledge of the unusual drainage patterns will help to ensure the accuracy and the completeness of sentinel nodes identification.