Case presentation:

• Female.
• 52 y.o.
• Skin lesion on the back of the torso.
• February 11, 2009: excision of skin lesion on the back of the torso. -Histology: malignant, epithelioid-cell, non-ulcerated melanoma; Clark’s level IV; Breslow thickness 2.7 mm; mild peritumoral lymphocyte infiltration; resection margins free from neoplastic infiltration.

Teaching points:

• Lymphatic mapping and sentinel lymph node biopsy represent a minimally invasive procedure for identifying occult microscopic disease.
• The goals of this technique are: 1) regional lymph node staging; 2) regional disease control; 3) potential cure (in patients with stage III disease).
•  The examination is usefully complemented by a SPECT/CT study, to correctly determine the anatomical location of sentinel lymph node(s) and to precisely identify in-transit or ectopically located sentinel nodes.