Epitrochlear Lymph Node Dissection and Axillary Lymph Node Biopsy. An Unusual Clinical Presentation in a Patient with Forearm Melanoma.

When primary melanomas of the forearm or hand metastasize to a lymph node, they usually affect axillary nodes, but in a small minority of patients epitrochlear node involvement can occur. The relationship between tumordraining axillary and epitrochlear nodes is still unclear, the latter being commonly considered as interval node or node located in a minor node field. The possible involvement of epitrochlear nodes demands anyway a detailed preoperative lymphoscintigraphy as well as a meticulous intraoperative search, even if the finding of positive SLN in the basin is infrequent. We present a case of a forearm melanoma with clinical involvement to epitrochlear nodes and metastasized to an axillary sentinel lymph node, with remaining axillary nodes uninvolved; the video illustrates the features of the case and highlights some technical details associated with epitrochlear lymph node dissection.