Popliteal lymphadenectomy for treating metastatic melanoma: case report

Sao Paulo Medical Journal

Sergio Renato Pais Costa¹  Sergio Henrique Couto Horta¹  Alexandre Cruz Henriques¹ 

[1] ,Faculdade de Medicina do ABC Teaching Hospital General Surgery ServiceSanto André São Paulo ,Brazil

关键词: Melanoma;    Lymphatic metastasis;    Lymphadenectomy;    Skin neoplasms;    Lower extremity;    Melanoma;    Metástase linfática;    Linfadenectomia;    Neoplasias cutâneas;    Extremidade inferior;   

DOI  :  10.1590/S1516-31802008000400009

来源: SciELO

【 摘 要 】

CONTEXT: Regional lymph node involvement in patients with malignant melanomas has been associated with poor prognosis. In-transit metastases also lead to poor long-term survival. Whereas for nodal disease only regional lymphadenectomy offers adequate locoregional control, for in-transit metastasis both local excision and isolated limb perfusion with chemotherapy plus tumor necrosis factor-alpha can be used for disease control. In cases of tumors located in the distal region of the legs, the lymphatic dissemination most commonly observed is to the inguinal chain. Consequently, therapeutic inguinal lymphadenectomy or even selective lymphadenectomy (sentinel lymph node biopsy) have been recommended. On the other hand, involvement of the popliteal chain is very rare. When this occurs, popliteal lymphadenectomy should be indicated. Local excision may be the logical approach for a few small in-transit metastases because of the low morbidity in this procedure, when compared with isolated limb perfusion. CASE REPORT: A case of melanoma of the heel with popliteal chain involvement and in-transit metastases is presented. This was treated by means of regional lymphadenectomy plus in-transit metastases excision, with a good postoperative course.

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