Question – confused

[cohanja]

If “in-transit melanoma metastasis” is defined as in-transit cutaneous malignant melanoma deposits between the site of excision and the draining lymph nodes – then I’m not clear on what value there is in a negative SLNB result? How does SLNB check for or catch if there is in-transit?

[Catherine Poole]

In-transit metastases is when melanoma can become trapped in the lymphatic vessels and grow to cause tumour nodules in the skin and subcutaneous tissues between the primary site and the regional lymph node basin. This usually happens in stage IV disease. I think what you have confused is where cells bypass the nodes and eventually develop into a tumor elsewhere in the body in stage III disease. The nodes do not always catch the melanoma cells and therefore the SLNB is not 100% guarantee of preventing further disease. In your situation, having a .3 melanoma, this would be highly unlikely and a SLNB would not be recommended.

[cohanja]

So, if in-transit is when melanoma becomes trapped between the primary site and the regional lymph node basin, then it would be possible to do WLE and SLNB. . everything appears to be “clean” but there really could be in-transit? So, then I’m confused as to how some people indicate when they had their WLE and SLNB. . .there were mets in transit identified . . how would those be identified if WLE and SLNB is looking at the primary site and the regional lymph nodes. . but not in between them?

[Author]

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