Franco J, Hansen LA, Miyamoto RT, Tann M, Moore MG. Sentinel lymph node mapping for malignant melanoma of the external auditory canal. World J Surg Proced 2015; 5(1): 173-176 [DOI: 10.5412/wjsp.v5.i1.173]
Corresponding Author of This Article
Michael G Moore, MD, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 550 N. University Blvd. RM 3170, Indianapolis, IN 46202, United States. mooremg@iupui.edu
Research Domain of This Article
Otorhinolaryngology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Surg Proced. Mar 28, 2015; 5(1): 173-176 Published online Mar 28, 2015. doi: 10.5412/wjsp.v5.i1.173
Sentinel lymph node mapping for malignant melanoma of the external auditory canal
Joel Franco, Lauren A Hansen, Richard T Miyamoto, Mark Tann, Michael G Moore
Joel Franco, St. Louis University School of Medicine, Saint Louis, MO 63103, United States
Lauren A Hansen, Richard T Miyamoto, Michael G Moore, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, United States
Mark Tann, Indiana University School of Medicine, Department of Radiology and Imaging Services, Indianapolis, IN 46202, United States
Author contributions: Franco J and Moore MG contributed to case write-up, review of literature and manuscript revision; Moore MG also assisted with the surgical procedure and designed the technique for lymph node mapping for the patient described; Hansen LA, Miyamoto RT and Tann M assisted in manuscript revision; Miyamoto RT also helped with the otologic portion of the surgery; Tann M assisted with the administration of the radio-isotope at the time of the procedure.
Ethics approval: The study was reviewed and Institutional Review Board approval was not required.
Informed consent: The subject of the case report, SL, provided consent for the use of her protected health information.
Conflict-of-interest: Joel Franco (primary author) and Michael G Moore (corresponding author) have no financial or other conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Michael G Moore, MD, Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, 550 N. University Blvd. RM 3170, Indianapolis, IN 46202, United States. mooremg@iupui.edu
Telephone: +1-317-9447057 Fax: +1-317-2783743
Received: September 10, 2014 Peer-review started: September 10, 2014 First decision: September 28, 2014 Revised: January 15, 2015 Accepted: January 30, 2015 Article in press: February 2, 2015 Published online: March 28, 2015 Processing time: 204 Days and 12.8 Hours
Abstract
We describe a novel technique for sentinel lymph node mapping and biopsy of a primary cutaneous malignant melanoma in the medial portion of the external auditory canal. The approach is illustrated through a case report and technical description of a procedure performed under general anesthesia on a 19-year-old female patient. Due to the hidden and sensitive location of the primary tumor in the medial external auditory canal, the lymphoscintigraphy injection had to be performed by the surgeon immediately prior to the resection of her cT2aN0M0 lesion. Final pathology revealed clear margins at the primary site resection and 2 intraparotid sentinel lymph nodes with microscopic foci of metastatic malignant melanoma, which led to further surgical management. A completion left parotidectomy and neck dissection yielded no additional metastatic disease in the fifty-five nodes that were evaluated. Using this technique, sentinel lymph node mapping and biopsy accurately predicted the highest risk lymph nodes for the primary lesion of the medial portion of the external auditory canal.
Core tip: We describe sentinel lymph node mapping and biopsy (SLNB) of a primary malignant melanoma in the external auditory canal. The usefulness of SLNB in this procedure allowed a focused surgical dissection to best assess regional lymph nodes and determine the extent of dissection needed to clear the disease. This novel technique is useful because it aids in establishing the single most important prognostic factor of a melanoma in the external auditory canal, regional lymph node status.
