Abstract
We performed sentinel node (SN) biopsy for 10 patients with cutaneous melanoma. We identified a total of 3 SNs in 2 of the 4 patients who underwent a blue dye method alone (average 1.5 SN). And 10 SNs were identified in all 6 patients who underwent a combination method using a preoperative lymphoscintigraphy and the blue dye method (average 1.67 SN). Six of 8 patients had a micrometastasis of melanoma in the resected SN. MART-1 is thought to be most specific and sensitive among the antibodies used to detect micrometastases. HMB-45 was negative in 3 of the 6 patients who had a metastatic SN. In a primary tumor from one of these 3 patients, most tumor cells in the dermis were negative for HMB-45. Two patients with a metastatic SN underwent complete lymph node dissection (CLND), and histological examination of the resected LNs revealed no additional metastasis. One of 4 patients with metastatic SN who did not undergo CLND developed lymph node metastasis 29 months later. Thus, we performed SN biopsies successfully using preoperative lymphoscintigraphy together with a vital dye. To identify SNs more accurately, we started to use an intraoperative gamma probe-guided sentinel node detection in addition to other methods.
