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Tumor Tip of the Week-Melanoma-In Transit Mets


Shave biopsy right arm 2/16/19 showed superficial spreading melanoma with Breslow thickness of .23mm, no ulceration. On 3/13/19 Wide Local Excision with 2cm margins showed 2 in transit metastasis. No regional lymph nodes were examined.

What is the pN category for this case?

  • pN0
  • pN1c

Answer: pN1c


Rationale: AJCC Cancer Staging Manual, Eighth Edition (Page 592). American College of Surgeons. Kindle Edition. Patients with microsatellite, satellite, and/or in‐transit metastases are categorized as N1c, N2c, or N3c disease according to the number of positive regional lymph nodes (irrespective of whether they were clinically occult or clinically detected). N1c designates patients with microsatellite, satellite, and/or in‐transit metastases but with no tumor‐involved regional lymph nodes; N2c designates those with one involved node; and N3c designates those with two or more involved nodes.

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