Melanoma pediatric: Estudi del gangli sentinella

Background. Sentinel lymph node (SLN) biopsy has not been systematically incorporated into the management of pediatric cancers. We present a case of pediatric melanoma in which a SLN biopsy and molecular studies were used. Material and Methods. A 21 month-old girl was diagnosed with malignant melanoma of the face when she presented with an ulcerated hyperpigmented preauricular lesion. A complete surgical resection, which included a skin graft, was performed. Staging studies included a positron emission tomogramphy (PET) and a biopsy of a sentinel yugulodigastric node. Immunohistochemical and molecular studies were performed. Results. The margins of the resected specimen, PET scan, and the immunohistochemical evaluation of the SLN were all negative for malignant melanoma. However, reverse transcriptase PCR using a GD2 probe was positive in the SLN sample. Conclusions. We encourage the incorporation of SLN biopsy into the evaluation of malignant melanoma in children. Its sensitivity is higher than PET scan, and it minimizes surgical interventions. In order to avoid additional surgical procedures, we recommend that the SLN be performed at the time of the original surgery. Finally, molecular methods allow for the detection of patients at risk of recurrence.