LYMPHATIC DRAINAGE TO TRIANGULAR INTERMUSCULAR SPACE LYMPH-NODES IN MELANOMA ON THE BACK

Methods: Lymphoscintigraphy with Tc-99m-antimony sulphide colloid was performed on patients with cutaneous melanoma of the back to define dr aining node fields and sentinel nodes before surgery, Results: One pat ient was found to have drainage from the back to sentinel lymph nodes in the triangular intermuscular spaces bilaterally, above and lateral to the scapula. Subsequently, drainage to this node field has been fou nd in 26% of 42 consecutive patients who have had lymphoscintigraphy p erformed for melanoma on the back. Conclusion: When performing lymphos cintigraphy to locate draining node fields and sentinel nodes in patie nts with melanoma on the back, it is important to look for drainage to the triangular intermuscular space node field by obtaining posterior and lateral scans. Any sentinel lymph nodes found in this field should be marked prior to surgery in the same way as nodes in other node fie lds are delineated so that they may be removed at surgery.