Investigation of sentinel lymph nodes of the axillary and cubital regions in upper-extremity malignant skin tumors: a series of 15 patients.

Abstract

Few articles have reported the location of sentinel lymph nodes (SLNs) in relation to skin-tumor location. We examined the location of SLNs in relation to skin-tumor location in the axillary and cubital regions. We attempted to detect SLNs of the axillary and cubital regions using 1% sulfan blue dye in 15 patients with melanoma and other skin cancers. SLNs were detected in 12 patients: in 10 patients, one SLN was detected; in 2 patients, two SLNs were detected. In 4 patients, tumor metastasis in SLNs was positive. In 69 samples, 16 metastatic lymph nodes were detected: tumor metastasis was recognized in 4 SLNs and in 12 other lymph nodes. In 8 patients, the SLNs were negative for tumor metastasis. Ten SLNs were found in 45 other samples; all lymph nodes were negative for tumor metastasis (false-negative rate, 0%). The SLNs were located in the following regions: central axillary nodes, 6 cases; lateral axillary nodes, 4 cases; subscapular nodes, 1 case; cubital node, 2 cases. Because the lateral and central lymph nodes drain the lymph channels of the upper extremity, the SLNs were mainly located in the central and lateral lymph nodes in the axillary region. However, the ulnar dorsal hand tumors and the dorsal little-finger skin tumors were connected to the cubital lymph node. It is necessary to check both the cubital and axillary regions when dyed lymph vessels are going toward the cubital region.