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Course of spread through lymph nodes?
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Course of spread through lymph nodes?

› Forums › General Melanoma Community › Course of spread through lymph nodes?

  • Post
    • February 19, 2017 at 9:16 pm
    AvaL
    Participant

      I just wondered if anyone knew of the typical course of spread via lymph nodes in groin. I've been told that typically there is spread to groin nodes (surface nodes) and it then travels to 'deeper' pelvic nodes. Is this the case? Anyone have spread to pelvic nodes with only very small amount to one groin one and/or spread to pelvic without any spread to groin? 

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    • Replies
        • February 20, 2017 at 12:16 am
        Aloha14
        Participant

          I had spread to the first sentinel node that was closer to the surface. The next sentinel node was a deep one and there was no melanoma in it. 

          • February 20, 2017 at 12:16 am
          Aloha14
          Participant

            I had spread to the first sentinel node that was closer to the surface. The next sentinel node was a deep one and there was no melanoma in it. 

            • February 20, 2017 at 1:02 am
            jennunicorn
            Participant

              I had 4 lymph nodes taken out during my SLNB. 3 were sentinel lymph nodes, two inguinal (in groin) and one pelvic. 1 lymph node removed was non-sentinel and was negative for melanoma at the time. So, I guess there can be sentinel nodes in the pelvic region which means that melanoma can spread to a deeper sentinel lymph node. The melanoma cells were all microscopic and stayed within the lymph nodes.

              • February 20, 2017 at 1:02 am
              jennunicorn
              Participant

                I had 4 lymph nodes taken out during my SLNB. 3 were sentinel lymph nodes, two inguinal (in groin) and one pelvic. 1 lymph node removed was non-sentinel and was negative for melanoma at the time. So, I guess there can be sentinel nodes in the pelvic region which means that melanoma can spread to a deeper sentinel lymph node. The melanoma cells were all microscopic and stayed within the lymph nodes.

                • February 20, 2017 at 10:54 am
                AvaL
                Participant

                  Thanks for these replies. There was a node mapped in the sentinel node mapping just where my hip bone is. So I'm assuming that it was sentinel. The surgeon didn't take it tho for testing as apparently SNLB doesn't usually take deep lymph nodes. His reasoning was that it tends to spread to surface nodes before deeper ones. I had a positive in my groin and CLND to that area. Guess it still makes me nervous knowing that  the hip one (I assume pelvis) remains and was untested. It also was closer (distance wise). 

                  • February 20, 2017 at 10:54 am
                  AvaL
                  Participant

                    Thanks for these replies. There was a node mapped in the sentinel node mapping just where my hip bone is. So I'm assuming that it was sentinel. The surgeon didn't take it tho for testing as apparently SNLB doesn't usually take deep lymph nodes. His reasoning was that it tends to spread to surface nodes before deeper ones. I had a positive in my groin and CLND to that area. Guess it still makes me nervous knowing that  the hip one (I assume pelvis) remains and was untested. It also was closer (distance wise). 

                      • February 20, 2017 at 4:50 pm
                      jennunicorn
                      Participant

                        I guess it is just up to the discretion of the surgeon if they take a deeper lymph node. In my opinion, he should have taken it, my surgeon did and didn't act like that was unusual or hard to do and didn't make my recovery longer or anything. Are you sure they didn't take some from the pelvic area during the CLND? Sorry you have to deal with this feeling of what if with it being in there still, that's not fair to you.

                        • February 20, 2017 at 4:50 pm
                        jennunicorn
                        Participant

                          I guess it is just up to the discretion of the surgeon if they take a deeper lymph node. In my opinion, he should have taken it, my surgeon did and didn't act like that was unusual or hard to do and didn't make my recovery longer or anything. Are you sure they didn't take some from the pelvic area during the CLND? Sorry you have to deal with this feeling of what if with it being in there still, that's not fair to you.

                        • February 20, 2017 at 4:03 pm
                        MichelleRHG
                        Participant
                          My first surgery was done locally 7 years ago with negative groin sentinel node. After 2 recent recurrences, my new surgeon at MDAnderson had a theory that I had 1 sentinel node in groin and 1 deep in the hip area at the same time based on current pathology. The tumor drained in opposite directions to 2 different sentinel nodes . She says this is rare and of course there is no proof. Basically I just had a large positive node removed from groin in November and another large one in deep pelvis/hip found in December. All 37 other nodes removed between the 2 recent surgeries were negative. I think the drainage system can be unpredictable. I have also learned some surgeons want to remove deep pelvic nodes also in the case of a larger positive groin node. Others are more conservative . pros and cons for both .
                          • February 20, 2017 at 4:03 pm
                          MichelleRHG
                          Participant
                            My first surgery was done locally 7 years ago with negative groin sentinel node. After 2 recent recurrences, my new surgeon at MDAnderson had a theory that I had 1 sentinel node in groin and 1 deep in the hip area at the same time based on current pathology. The tumor drained in opposite directions to 2 different sentinel nodes . She says this is rare and of course there is no proof. Basically I just had a large positive node removed from groin in November and another large one in deep pelvis/hip found in December. All 37 other nodes removed between the 2 recent surgeries were negative. I think the drainage system can be unpredictable. I have also learned some surgeons want to remove deep pelvic nodes also in the case of a larger positive groin node. Others are more conservative . pros and cons for both .
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