Desmoplastic and neurotropic melanoma

Analysis of 33 patients with lymphatic mapping and sentinel lymph node biopsy

Authors

  • Lyndon D. Su M.D.,

    Corresponding author
    1. Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
    2. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
    • Department of Pathology, Division of Dermatopathology, University of Michigan Medical Center, Medical Sciences I, M5224, 1301 Catherine Street, Ann Arbor, MI 48109-0602
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    • Fax: (734) 936-2756

  • Douglas R. Fullen M.D.,

    1. Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
    2. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Lori Lowe M.D.,

    1. Department of Pathology, University of Michigan Medical Center, Ann Arbor, Michigan
    2. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Timothy S. Wang M.D.,

    1. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Jennifer L. Schwartz M.D.,

    1. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Vincent M. Cimmino M.D.,

    1. Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Vernon K. Sondak M.D.,

    1. Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan
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  • Timothy M. Johnson M.D.

    1. Department of Dermatology, University of Michigan Medical Center, Ann Arbor, Michigan
    2. Department of Surgery, University of Michigan Medical Center, Ann Arbor, Michigan
    3. Department of Otorhinolaryngology, University of Michigan Medical Center, Ann Arbor, Michigan
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Abstract

BACKGROUND

Desmoplastic and neurotropic melanoma (DNMM) occasionally metastasizes to regional lymph nodes and extranodal sites. The value of sentinel lymph node biopsy (SLNB) has not been demonstrated clearly for patients with DNMM. The authors report on the utility of SLNB in the management of patients with DNMM.

METHODS

The authors identified 33 patients with DNMM who were seen during a 5-year period in their institution who underwent lymphatic mapping and SLNB. Clinical and histopathologic data were reviewed.

RESULTS

Thirty-three patients with DNMM underwent SLNB (mean Breslow depth, 4.0 mm; median, 2.8 mm). There were 25 male patients and 8 female patients with a median age of 61 years (range, 31–86 years). Fifty-two percent of tumors presented in the head and neck region, and 24% were associated with lentigo maligna. Four of 33 patients (12%) without clinical evidence of metastatic disease who underwent SLNB had at least 1 positive sentinel lymph node. No additional positive lymph nodes were found in subsequent therapeutic regional lymphadenectomy in any of these four patients.

CONCLUSIONS

SLNB detected subclinical metastases of DNMM to regional lymph nodes. SLNB at the time of resection can provide useful information to guide early treatment and, coupled with lymphadenectomy in positive patients, may limit tumor spread and prevent recurrence at the draining lymph node basin. Cancer 2004. © 2003 American Cancer Society.

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