Sentinel lymph node (SLN) biopsy has become widely accepted as a method of staging in the regional lymph nodes of patients with malignant melanoma. Popliteal lymph nodes have been rarely identified as SLNs in patients with melanoma at or distal to the knee. However, its significance has not been well established. We reported a case of a patient with melanoma on the heel, who had positive SLN metastases in both popliteal and groin lymph nodes. In addition, experience with the past cases metastasized to popliteal lymph nodes in our hospitals were reviewed. Among 76 patients with melanoma of the distal lower limb, five (6.6%) developed popliteal lymph node metastases in its clinical course. The primary tumor sites in four of five patients were located on the heel, especially on the lateral or proximal aspects. Although elective lymphadenectomy of popliteal node seems to be unnecessary considering the low incidence of metastasis, once the popliteal node is identified as SLN on lymphoscintigraphy, biopsy procedureshould be performed. [Skin Cancer (Japan) 2003; 18: 298-302]
