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KMID : 0358820090360040485
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Journal of Korean Society of Plastic and Reconstructive Surgeons
2009 Volume.36 No. 4 p.485 ~ p.488
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Popliteal Lymph Node Dissection in Lower Extremity Malignant Melanoma
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Chang Hak
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Abstract
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Purpose: Malignant melanoma of the lower extremity is well known to metastasize to the lymph nodes of the groin. However, in rare cases, the initial site of the nodal disease can be the popliteal fossa. As of yet, there has not been any report on cases with popliteal lymph node metastasis in Koreans. In the following report, authors would like to present two cases of popliteal node metastasis.
Methods: A 60-year-old male patient presented with nodular mass in his left sole. He had popliteal node metastasis detected on preoperative positron emission tomography(PET). Another 67-year-old man presented with pigmented lesion in his right heel. He also had popliteal node metastasis detected on the MRI. They underwent wide excision of the primary lesion with popliteal node dissection. Received April 28, 2009 Revised May 22, 2009 Accepted June 8, 2009 Address Correspondence: Hak Chang, M.D., Ph.D., Department of Plastic and Reconstructive Surgery, Research Institue of Plastic and Reocnsturctive Sugery, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744, Korea. Tel: 02) 2072-3086/Fax: 02) 3675-7792/ E-mail: hchang@snu.ac.kr *본 논문은 2007년 제 63차 대한성형외과학회 학술대회에서 구연 발표되었음.
Results: In the first case, 2.5×2.5cm sized metastatic melanoma in popliteal node was pathologically confirmed. There were no postoperative complications, and to date (18 months after the surgery), the patient is alive with no evidence of disease. In the second case, multiple(4) metastatic melanoma in popliteal nodes was confirmed. The patient is alive, but has had interferon therapy for liver metastasis.
Conclusion: By increasing the use of lymphoscintigraphy or PET as a preoperative diagnostic work-up for metastasis, even popliteal node metastasis undetectable in a physical exam becomes detectable. When metastatic lymph node is found, node dissection is the standard of care. Therefore, it is essential that we know the anatomy and surgical technique for popliteal lymph node dissection.
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KEYWORD
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Malignant melanoma, Popliteal fossa, Sentinel, Lymph node
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