Aberrant sentinel nodes in malignant melanoma

The option of sentinel lymph node biopsy for patients with a cutaneous malignant melanoma has allowed an alternative to the traditional approaches to lymph node basin surgery. Lymphatic mapping usually identifies the sentinel node(s) in a recognised lymphatic basin, however aberrant nodes may occasionally be identified outside these areas. The notes of 100 consecutive patients with a localised cutaneous malignant melanoma, who had a sentinel lymph node biopsy in our unit, were reviewed. Lymphatic mapping identified three patients with aberrant sentinel lymph nodes. Failure to remove an aberrant sentinel lymph node harbouring metastatic melanoma may reduce significantly the chance of control or cure of the disease. In order to reduce this risk we advocate lymphatic mapping prior to surgical management of the draining lymph nodes of a cutaneous malignant melanoma.