The lymphatic drainage of cutaneous melanomas located on the upper trunk is often complex and sometimes follows an unexpected pattern. Occasionally, even direct drainage to cervical lymph nodes is seen. In this case series, 3 patients with lymphatic drainage to the neck derived from melanomas located over the manubrium sterni are described. There appears to be a restricted area that involves the manubrium sterni from which lymphatic drainage to different cervical node basins appears more frequent. SPECT/CT was helpful in visualizing these patterns and for the localization of the sentinel nodes.
From the Departments of *Head and Neck Surgery and Oncology, †Surgery, and ‡Nuclear Medicine, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
Received for publication December 15, 2011; and revision accepted May 30, 2012.
Conflicts of interest and sources of funding: none declared.
Reprints: Hidde J. Veenstra, MD, Department of Head and Neck Surgery and Oncology and Department of Surgery, The Netherlands Cancer Institute – Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands. E-mail: firstname.lastname@example.org.