DOI: https://doi.org/10.36347/sjmcr.2025.v13i12.001

Pages: 2908-2914

Cutaneous melanoma is a malignant tumor with a high metastatic potential, whose staging largely depends on regional lymph node status. Lymphoscintigraphy, combined with sentinel lymph node biopsy, constitutes an essential step in the staging workup, allowing precise identification of metastases while limiting the morbidity associated with systematic lymph node dissections. The reported case describes a 54-year-old female patient with a plantar acral lentiginous melanoma. Lymphoscintigraphy, performed after injection of technetium-99m colloids, revealed a hyperactive right inguinal sentinel lymph node, with secondary lymphatic relays. Intraoperatively, combined localization using a handheld gamma detector and a portable GammaSUP-II gamma camera enabled targeted excision of the node, whose histopathological analysis confirmed the presence of micrometastases. The primary lesion, meanwhile, was an in situ melanoma. Postoperative course was marked by a cutaneous tissue loss requiring reconstructive follow-up, without major infection. This case illustrates the crucial utility of lymphoscintigraphy and intraoperative localization for personalized staging, particularly in locations such as the acral region where lymphatic drainage can be complex.