Rosales Jose A, Palacios Christian A, Fernandez Trokhimtchouk Tatiana, Flores Luis F, Morillo Cox Álvaro, Crespo Martinez Joseline K, German Melissa
General Surgery, Universidad Internacional del Ecuador/Axxis Hospital, Quito, ECU.
Head and Neck Surgery, Hospital Carlos Andrade Marín, Quito, ECU.
Cureus. 2023 Jun 8;15(6):e40136. doi: 10.7759/cureus.40136. eCollection 2023 Jun.
This article discusses acral melanoma, a rare subtype of melanoma often presented at the later stages of the disease and is, thus, associated with poor survival rates, especially in patients with a lower socioeconomic status. Surgical resection is the primary treatment option for localized acral melanoma, while amputation is often necessary for tumors on the digits or the midfoot. Lymphadenectomy may be necessary for patients with regional lymph node involvement; however, the therapeutic role of dissection remains controversial. Here, we present the case of a 68-year-old man with acral melanoma who underwent a Lisfranc amputation and endoscopic groin lymph node dissection for ganglionic metastasis. In Ecuador, this is the first reported case of endoscopic groin lymphadenectomy for regional lymph node metastasis secondary to acral melanoma. The discussion explores the role of sentinel lymph node biopsy and the completion of lymph node dissection in managing regional lymph nodes in melanoma patients. This case study aims to contribute to the growing knowledge on acral melanoma, assess the need for better patient care, and analyze the role of minimally invasive techniques for inguinal lymph node dissections.
本文讨论肢端黑色素瘤,这是黑色素瘤的一种罕见亚型,常在疾病后期出现,因此与低生存率相关,尤其是在社会经济地位较低的患者中。手术切除是局限性肢端黑色素瘤的主要治疗选择,而对于手指或中足的肿瘤,截肢往往是必要的。对于有区域淋巴结受累的患者,可能需要进行淋巴结清扫术;然而,清扫术的治疗作用仍存在争议。在此,我们报告一例68岁的肢端黑色素瘤男性患者,其因神经节转移接受了Lisfranc截肢术和内镜腹股沟淋巴结清扫术。在厄瓜多尔,这是首例因肢端黑色素瘤继发区域淋巴结转移而进行内镜腹股沟淋巴结清扫术的报道病例。讨论探讨了前哨淋巴结活检以及完成淋巴结清扫术在黑色素瘤患者区域淋巴结管理中的作用。本病例研究旨在为关于肢端黑色素瘤的知识增长做出贡献,评估改善患者护理的必要性,并分析微创技术在腹股沟淋巴结清扫术中的作用。