Slovenská chirurgia 1/2013

Value of sentinel node biopsy in surgical treatment of thin melanoma – case report

Melanoma is the most malignant cutaneous tumor. In the present time, sentinel node biopsy is a standard of care in patients with thickness of primary lesion more than 1 mm. Authors present a case report of a patient after excision of cutaneuos tumor from the right shoulder which was initially histopathologically diagnosed as melanoma in situ. This patient developed after eight years regional supraclavicular and axillary lymphadenopathy, and therefore the histopatological examination of the specimen was revised. This revision classified the primary tumor as a superficial spreading melanoma Breslow 0.9mm, Clark III with mitotic rate of 5 mitoses/1 mm². On the basis of the histopathologic finding of metastatic involvement of the supraclavicular lymph node a complete dissection of the right axillary lymph nodes was performed. Metastases were present in all dissected axillary lymph nodes. Authors discuss individual consideration for offering sentinel node biopsy to patients with melanoma of thickness less than 1 mm if risk factors such as mitotic rate equal to or more than 1 mitosis/1 mm² and ulceration are present.

Keywords: thin melanoma, sentinel node biopsy.