Pathological assessment of tumor biopsy specimen and surgical sentinel lymph node dissection in patients with melanoma

Vol. 55 No. 3 Suppl., 2014
This supplement was not sponsored by Outside Organizations.


Gheorghe Noditi, Cristian C. Nica, Horatiu Pompiliu Petrescu, Codrut Ivan, Zorin Petrisor Crainiceanu, Tiberiu Bratu, Alis Dema

Introduction: Actual trends of cutaneous malignant melanoma show a faster increase then other forms of cancer. Early detection and diagnosis, and accurate pathologic interpretation of the biopsy specimen is extremely important for the treatment and prognosis of clinically localized melanoma. The surgical approach to cutaneous melanoma patients with clinically uninvolved regional lymph nodes remains controversial. Materials and Methods: A retrospective study of melanoma cases was conducted in the Casa Austria Department of Plastic and Reconstructive Surgery, Emergency County Hospital, Timisoara, Romania. We have analyzed the medical records of 21 patients that underwent surgical treatment for different stages of melanoma in the period 2008-2012. For histopathological diagnosis of melanoma and the sentinel lymph node(s) status, tissular fragments were routinely processed. For the difficult cases, additional immunohistochemical investigation was done. Results: A positive family history was noted in two cases. The presence of different sizes and localization of pigmented nevi was found in 38% of the cases. Different types of melanoma like superficial spreading melanoma, nodular melanoma or lentigo malignant melanoma and acral lentiginous melanoma was described. The surgical treatment consisted in all cases in wide excision of the primary tumor and prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination. A positive biopsy of the sentinel lymph node was noted in 4.9% of the cases. Conclusions: The surgical treatment combining the wide excision of the primary tumor with respect to safe oncological limits with the prophylactic dissection of sentinel lymph node after lymphoscintigraphy examination had the confirmation done by the pathologic interpretation of the biopsy specimen showing that all the patients had a Breslow index more than 1.5 mm.

Corresponding author: Horatiu Pompiliu Petrescu, Assistant Professor, MD, PhD; e-mail:

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Georgeta Ligia Stanescu, Iancu Emil Plesea, Radu Diaconu, Cristian Gheonea, Corneliu Sabetay, Dalia Tistea, Elena Carmen Niculescu

Meckel s diverticulum (MD) represents one of the most common malformations of the digestive tract, being a vestige of the proximal end of omphalo-mesenteric duct, which normally obliterates and atrophiates between the sixth and ninth week of intrauterine life. It is estimated that 2-4% of people are carriers of this malformation. The interest in this organ study lies in the fact that it presents its own non-specific pathology, mimicking a cecal, colon or small intestine pathology. It seems that most MD cases are asymptomatic (AS MD), being arbitrary discovered during surgeries, whereas only a small part are being symptomatic (S MD). MD may be clinically expressed at any age but it is more common in children. In our study, we evaluated a group of 44 children, aged between 0 and 16 years, diagnosed with AS MD (15 cases) or S MD (29 cases). Of the 29 S MD cases, 14 had intestinal obstruction, seven cases showed lower gastrointestinal bleeding, five cases presented acute inflammation (diverticulitis) and three cases were complicated with peritonitis; 15 cases of AS MD were discovered during surgical interventions for acute appendicitis (14 cases) or inguinal hernia (one case). Most cases of MD were recorded between 1-4-year-old and 7-16-year-old.

Corresponding author: Cristian Gheonea, Associated Professor, MD, PhD; e-mail:

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