Resection of metastatic melanoma following wire localization guided by computed tomography or ultrasound

Melanoma is an aggressive tumour with the propensity to metastasize through the lymphatic system and blood. Patients at high risk for developing metas tatic disease are evaluated clinically together with chest X-rays and when indicated computed tomography (CT) scans. Wire localization is routinely us ed in non-palpable breast cancer to facilitate surgical resection. This stu dy demonstrates the applicability of wire localization and surgical resecti on of non-palpable, deep subcutaneous or intramuscular metastatic melanoma detected by CT or ultrasound. The medical records of six patients with mali gnant melanoma were retrospectively reviewed. Each patient with malignant m elanoma developed metastatic involvement detected by CT scan or ultrasound at the UCSF/Mount Zion Medical Center, California, USA. A Copanz needle was inserted into the tumours under local anaesthesia. The patients were trans ported to the operating room and underwent wire guided surgical resection o f the tumour under general anaesthesia or intravenous sedation. In all six patients the tumour was successfully resected following CT- or ultrasound-g uided wire localization of the metastatic foci. In conclusion, nonpalpable metastatic melanoma may be resected using CT- or ultrasound-guided wire loc alization. This technique offers several advantages, including minimal surg ical dissection, shorter operative times and decreased postoperative morbid ity. (C) 1999 Lippincott Williams & Wilkins.