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. 2008 Sep;3(3):282-5.
doi: 10.1007/s11552-008-9107-1. Epub 2008 May 8.

Tattoo pigment interpreted as lymph node metastasis in a case of subungual melanoma

Steven L Peterson  1 , Lela A Lee, Kagan Ozer, James E Fitzpatrick
Affiliations

Tattoo pigment interpreted as lymph node metastasis in a case of subungual melanoma

Steven L Peterson et al. Hand (N Y). 2008 Sep.

Abstract

We present a patient with subungual melanoma of the thumb who, during radioisotope-guided selective sentinel lymphadenectomy, was found to have black, hard lymph nodes at multiple axillary node levels. This finding was interpreted intraoperatively as clinical evidence of metastasis and a formal axillary dissection was carried out. Pathological examination of excised nodes failed to demonstrate metastasis but instead showed collections of tattoo pigment.

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Figures

Figure 1
Figure 1
a Striae present in subungual area of thumb. b Pigmentation extending into pulp of thumb tip.
Figure 2
Figure 2
Darkly pigmented nodes present in ipsilateral axilla.
Figure 3
Figure 3
Follow-up demonstrating level of amputation and adequate opposition.
Figure 4
Figure 4
Histopathology demonstrating the density of ink pigment present within the nodes.
See this image and copyright information in PMC

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