Nakamura Yoshiyuki, Nakamura Yasuhiro, Fujisawa Yasuhiro, Obara Saeko, Furuta Junichi, Kawachi Yasuhiro, Otsuka Fujio
Department of Dermatology, University of Tsukuba, Tsukuba, Japan.
Lymphat Res Biol. 2012 Sep;10(3):118-21. doi: 10.1089/lrb.2012.0006.
It is extremely rare that swelling of pelvic lymph nodes is found when inguinal lymph nodes contain only a microscopic amount of disease without enlargement. A 69-year-old woman with malignant melanoma of the heel was treated with a wide, local excision. About four years after the initial operation, a left common iliac node was enlarged although all lymph nodes in the obturator, external iliac and inguinal regions were not enlarged. Rapid pathological examination of the resected swollen lymph nodes revealed involvement of malignant melanoma, and left pelvic and groin dissection was undertaken. Histologically, multiple lymph node metastases were found in the common iliac, obturator, external iliac and inguinal regions. This case indicates that sentinel lymph node biopsy may be worth considering even for stage IA malignant melanoma of the lower extremity.
当腹股沟淋巴结仅含有微量病变且未肿大时，发现盆腔淋巴结肿大的情况极为罕见。一名69岁足跟恶性黑色素瘤女性接受了广泛局部切除治疗。初次手术后约四年，左侧髂总淋巴结肿大，而闭孔、髂外和腹股沟区域的所有淋巴结均未肿大。对切除的肿大淋巴结进行快速病理检查发现有恶性黑色素瘤累及，遂进行了左侧盆腔和腹股沟清扫术。组织学检查发现，髂总、闭孔、髂外和腹股沟区域均有多处淋巴结转移。该病例表明，即使对于下肢IA期恶性黑色素瘤，前哨淋巴结活检也可能值得考虑。
