Murray William, Knightly Nauar, Kennedy Sharon, Kelly Jack
Plastic Surgery, Galway University Hospitals, Galway, Ireland
Plastic Surgery, Galway University Hospitals, Galway, Ireland.
BMJ Case Rep. 2025 Jul 8;18(7):e265050. doi: 10.1136/bcr-2025-265050.
Sentinel lymph node biopsy is imperative in the management of melanoma and allows for accurate histological assessment of nodal basins in stage 1B disease, or greater. Indocyanine green (ICG) represents a somewhat novel localisation modality that may confer a decreased risk of anaphylaxis and reduced risk of skin discolouration. A middle childhood (6-11 years) boy with a 3-month history of a new, pigmented, right cheek lesion was referred for evaluation. Excisional biopsy revealed a pigmented epithelioid melanocytoma.After the MDM discussion, a WLE and sentinel lymph node biopsy were recommended. The sentinel node was successfully identified using intraoperative ICG fluorescence imaging. There were no adverse outcomes such as skin staining or lack of dye uptake.Although initially positive for nodal micrometastases, management consisted of clinical follow-up with 3 monthly ultrasound scans of the neck. To date, there is no evidence of recurrence.
前哨淋巴结活检对于黑色素瘤的治疗至关重要，可对ⅠB期及更晚期疾病的淋巴结区域进行准确的组织学评估。吲哚菁绿（ICG）是一种较为新颖的定位方式，可能会降低过敏反应风险和皮肤变色风险。一名6至11岁的儿童男性，右脸颊出现一个新的色素沉着病变3个月，前来接受评估。切除活检显示为色素性上皮样黑素细胞瘤。经过多学科讨论后，建议进行广泛局部切除和前哨淋巴结活检。术中使用ICG荧光成像成功识别出前哨淋巴结。未出现皮肤染色或染料摄取不足等不良后果。尽管最初淋巴结微转移呈阳性，但治疗方案为临床随访，每3个月对颈部进行超声扫描。迄今为止，尚无复发迹象。
