THE IMPACT OF ULTRASOUND SCANNING IN THE STAGING AND FOLLOW-UP OF PATIENTS WITH CLINICAL STAGE-I CUTANEOUS MELANOMA

In 85 patients with intermediate to high risk cutaneous melanoma, conc omitant palpation and ultrasound scanning (US) of the axillary and ing uinal sites were performed in order to detect any locoregional lymph n ode metastases at pre-operative staging and postoperative monitoring. At 12 months follow-up, US identified 12 out of 13 (92%) histologicall y proven metastases, while palpation indicated metastatic disease in o nly 3 (23%) patients. Metastases were intranodal in 6 out of 12 cases detected with US, and extranodal in all the 3 cases identified by palp ation, thus confirming that US is more effective than palpation in the early detection of lymph node metastases from melanoma. US was also m ore effective in discriminating all non-neoplastic lymph nodes: its ov erall specificity was 100% versus 85% for palpation. Thus, when carrie d out by well-trained radiologists, US is a very useful diagnostic too l for the surgical oncologist dealing with melanoma patients. (C) 1997 Elsevier Science Ltd.