Introduction Vulvar melanoma has a high propensity for lymphatic spread to inguinal lymph nodes. Groin sentinel lymph node biopsy is considered a part of the management of primary vulvar melanoma. Yet, the role of performing sentinel lymph node biopsy in the management of patients with negative nodes in primary surgery, who develop recurrent vulvar melanoma, is less clear than in the case of primary tumors. Nevertheless, lymph nodes status in recurrent disease can provide valuable information to guide further therapy. Sentinel mapping in a previously scarred area is challenging and the most suitable mapping technique has not been determined. In this video, we demonstrate the technical feasibility of repeat sentinel lymph nodes biopsy for recurrent vulvar melanoma using intraoperative fluorescent indocyanine green (ICG) detection.

Description The video demonstrates ICG mapping technique in recurrent vulvar melanoma. The injection site and ICG positive nodes are shown. Implication: Sentinel mapping in recurrent vulvar melanoma with ICG tracer technique is feasible, even in previously dissected groins.