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Intracapsular melanoma: a new pitfall for sentinel lymph node biopsy
  1. B G Howell1,
  2. J E Lipa2,
  3. D M Ghazarian3
  1. 1Division of Pathology and Division of Plastic Surgery, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada
  2. 2Division of Plastic Surgery, Toronto General Hospital
  3. 3Division of Pathology, Toronto General Hospital
  1. Correspondence to:
 D M Ghazarian
 University of Toronto, Division of Pathology, 11th floor, Eaton Wing, Room 444, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto Ontario M5G2C4, Canada;brandon.howell{at}

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Sentinel lymph node biopsy (SLNB) has become an established technique for the staging and treatment of cutaneous melanoma.1,2 SLNB is very accurate in predicting tumour burden in the remaining regional lymph node basin and is also the most important independent prognostic indicator for recurrence and survival when compared with factors such as tumour thickness and ulceration.1

Large retrospective studies have shown that positive sentinel lymph nodes (SLNs) contain metastatic foci of melanoma cells in the subcapsular, sinusoidal or parenchymal regions. The subcapsular region is most commonly associated and up to 86% of metastatic foci become seeded in this area.3 An important caveat of SLNB, however, is …

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  • Competing interests: None.