Clinical Case of Tattoo Pigment Detection in Sentinel Lymph Nodes Against the Background of Melanoma

Post-tattoo complications are characterized by polymorphism and variability in clinical manifestations. The accumulated data suggests that even the absence of complaints and the satisfactory appearance of a tattoo are not sufficient indicators of tattoo safety. As evidence, we present a clinical case of tattoo pigment detected in sentinel lymph nodes, resected due to melanoma of the torso. Objective. Demonstration of the potential spread of tattoo pigment to regional lymph nodes with the development of granulomatous inflammation in a patient with early-stage melanoma of the skin of the left breast during sentinel lymph node biopsy. Material and methods. Patient P., 48 years old, presented to the National Medical Research Center of Radiology on July 13, 2024, with complaints of an enlarging lesion on the skin of the left breast, noted since November 2023. A total biopsy was performed, and a histological examination was conducted. The diagnosis based on the study: C.43.5. Malignant melanoma. The patient was referred to the oncological surgery department No. 71 at the Botkin Hospital, where the scar was excised and the sentinel node biopsy was performed under ICG-navigation, followed by histological and immunohistochemical examination. Results. It was retrospectively established that this lesion had been present since childhood; however, since November 2023, the patient noted growth of the lesion. Objective examination: The patient’s condition is satisfactory, and no other organ or system pathologies were identified. Local status: Status after total biopsy of the lesion. Scar excision and sentinel node biopsy under ICG-navigation were performed. According to the histological examination, the conclusion was made: postoperative scar without tumor growth. Sentinel lymph nodes showed no tumor growth but were enlarged due to granulomatous inflammation surrounding the foreign body (pigment), accumulated in the sinuses and under the capsule. Conclusion. The presented clinical case is an example of the emergence of hidden post-tattoo complications, accompanied by the accumulation of pigment in regional lymph nodes and the development of granulomatous inflammation around the tattoo pigment. © 2024, Media Sphera Publishing Group. All rights reserved.