Presurgical ultrasound-guided anchor-wire marking of soft tissue metastases in stage III melanoma patients

BACKGROUND. Due to increased sensitivity of diagnostic procedures, sob tiss ue metastases in melanoma patients are frequently detected very early. Howe ver, small sizes, deep location, or position close to vulnerable structures could render subsequent surgery quite difficult. OBJECTIVE. To test the feasibility and effectiveness of presurgical ultraso und-guided anchor-wire marking of melanoma metastases. METHODS. We selected melanoma patients with cytologically proven metastases in clinical stage III which were either unfavorably located or which have failed removal by previous surgery. Anchor-wire marking was performed ultra sound guided and free-hand style without the use of local anesthesia. RESULTS. Twelve procedures in nine patients were well tolerated without any complications. In 11 cases the wire tip proved to be located within the tu mor lesion; in one case the wire tip missed the target by less than 5 mm an d thus was close enough to support appropriate surgery. Earlier, 3 of the 1 2 study lesions had undergone unsuccessful surgery. The median diameter of the removed metastases was 18.5 mm (range 7-30 mm). CONCLUSION. Ultrasound-guided anchor-wire marking of unfavorably located me lanoma metastases is feasible and might facilitate subsequent surgery.