Sentinel Lymph Node Melanosis: A Report of Two Cases of Regressed Melanoma Metastases
SM Dermatology Journal
Tumoral melanosis is found on histopathologic evaluation of a primary melanoma and is typically caused by regression of the tumor. The prognostic value of regression related to primary cutaneous melanoma has been controversial. Very few cases of melanosis in the sentinel lymph node have been described. We present two patients who presented with cutaneous melanoma and were found to have completely regressed metastatic melanoma present within the sentinel lymph node. One patient underwent
... on lymph node dissection whereas the other opted for observation. Based on the outcomes of our two cases as well as review of other case reports of this phenomenon we discuss the biologic significance of sentinel lymph node melanosis and how it should be interpreted in relation to adjuvant therapies, staging, and follow up. Based on the unpredictable course associated with this finding we recommend that these patients be treated in a multidisciplinary fashion with treatment decisions influenced by the patient's goals of care.