Essay On Malignant Melanoma

The need of perioperative histology in malignant melanoma and sentinel lymph node biopsy

1. INTRODUCTION
A noteworthy increase in melanoma incidence have been observed in the last few decades, this has led to an improvement in the diagnostic ability and early treatment that has led to an increase in the survival index. Even though, there has been improvement in the management of the disease, this has still not resulted in better control of neoplastic spread to regional lymph nodes for lesions that are thicker than 0.76 mm.

Malignant melanoma is a neoplasm arising from melanocytes. Melanocytes are melanin producing cells that are located in the bottom layer of the epidermis, which is called the stratum basale and they are also present in hair follicles. Melanocytes are a type of specialized skin

To identify a SNL, injection of blue dye or radiolabeled colloid around the surrounding area of the tumor is done. This will identify the SNL in most of the patients, and the status of the SNL closely predicts the status of the surrounding regional lymph nodes in that area.

An example is, in patients that have breast cancer and are clinically tested and identified as node-negative, the sentinel lymph node biopsy will in this case be identified without axillary node involvement. This will therefore obviate the need of a more extensive surgery.

Despite the fact that there is a lot of variability in the selection criteria and the technique, SNL is steadily identified in about 96% of the cases, and it predicts the status of the remaining axillary lymph nodes in less than 95% of the cases. The false negative rate of a SNLB was reported to be set between 5-10%, but lower rates are achievable by experienced