Discussion

Sentinel nodes are occasionally found in the popliteal fossa [1]. If that happens, the primary lesion is usually situated on the calf. Although the majority of melanomas on the calf drain to sentinel nodes in the groin, the popliteal fossa has to be imaged in patients with a melanoma below the knee.

This patient was treated early after the introduction of lymphatic mapping. No flow images were obtained at that time. As a consequence, it could not be determined whether the nodes in the groin were sentinel (first-tier) nodes or second-tier nodes. The drainage order of the popliteal nodes was also not clarified. The blue dye was not helpful in this case. All radioactive nodes were removed to err on the safe side.

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