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INTRODUCTION: Metastatic melanoma in the popliteal fossa is extremely rare with less than 5% of metastatic deposits from melanomas in the leg and foot draining into the popliteal region, while the majority drain to the inguinal region. If popliteal spread is clinically overlooked, it may lead to recurrence. Together with the accompanying literature review, this case report emphasises the need for thorough clinical and radiological assessment in the management of malignant melanomas of the lower extremity. PRESENTATION OF CASE: A 66-year-old gentleman presented with metastatic melanoma to the right popliteal fossa three years after the diagnosis of a primary lesion in the right mid-calf with ipsilateral inguinal lymph node metastasis for which he underwent a right wide local excision and complete groin lymph node dissection. DISCUSSION: Studies show that a lesion anywhere below the knee can metastasize to the popliteal fossa. The groin can be the primary or secondary lymphatic drainage site in conjunction with the popliteal fossa. Concurrent popliteal and inguinal drainage may either reflect two separate lymphatic channels with popliteal nodes being the primary drainage site, or a single channel which drains to the popliteal basin as an interval node. Hence, popliteal lymph nodes should be carefully assessed in distal lower extrem- ity lesions including melanomas. Modalities to delineate lymphatic flow and identify micrometastatic deposits should be used and when metastatic popliteal disease is identified, radical popliteal dissection is advised. CONCLUSION: Proper clinical assessment, good surgical technique, a high index of suspicion, and active surveillance are all essential to ensure early detection of metastasis to the popliteal region., peer-reviewed

This project is focused on studying the importance of FISH technique (Fluorescence In Situ Hybridization) for the diagnosis of cutaneous melanomas and the determination of ambiguous cases. The study begins with the complete protocol that is followed in the resolution of a complex case, since the sample arrives at the Pathological Anatomy Department of Hospital Clínic of Barcelona until the final report for the patient is concluded. This protocol deals with an initial microscopic study, an immunohistochemical analysis and, in case of a non-conclusive diagnosis, a FISH technique is implemented. Thus, the diagnostic criteria observable under the microscope that helps to differentiate malignant tumors from benign ones are exposed, emphasizing that it is not always possible to conclude this difference without the use of FISH. To analyze it, a study was carried out with 10 cases, of which 3 of them have been melanoma and the remainder have been benign. In almost all of them (with one exception) it has been essential to use the technique studied to solve them. Of these cases, there are some that have allowed us to demonstrate that histological and immunological studies are often inadequate to recognize the seriousness of the tumor and that, in these cases, the use of a technique such as FISH can be decisive for a correct diagnosis. Simultaneously to these cases, one geographic study has been carried out. It refers to the number of hospitals throughout Spain that use FISH to diagnose cutaneous melanomas. A bibliometric study has also been carried out and it includes a set of outstanding articles that focus on emphasizing the importance of this technique in this type of diagnosis. From these studies the year of publication has been valued with the intention of knowing the interest that FISH has aroused around the world and since when it began to be studied in depth. With this project it is possible to confirm the hypothesis of the relevance of the technique in this field and makes remarkable the lack of its use and study, in contrast to the positive results obtained

Over the past few decades, Fourier transform infrared (FTIR) spectroscopy coupled to microscopy has been recognized as an emerging and potentially powerful tool in cancer research and diagnosis. For this purpose, histological analyses performed by pathologists are mostly carried out on biopsied tissue that undergoes the formalin-fixation and paraffin-embedding (FFPE) procedure. This processing method ensures an optimal and permanent preservation of the samples, making FFPE-archived tissue an extremely valuable source for retrospective studies. Nevertheless, as highlighted by previous studies, this fixation procedure significantly changes the principal constituents of cells, resulting in important effects on their infrared (IR) spectrum. Despite the chemical and spectral influence of FFPE processing, some studies demonstrate that FTIR imaging allows precise identification of the different cell types present in biopsied tissue, indicating that the FFPE process preserves spectral differences between distinct cell types. In this study, we investigated whether this is also the case for closely related cell lines. We analyzed spectra from 8 cancerous epithelial cell lines: 4 breast cancer cell lines and 4 melanoma cell lines. For each cell line, we harvested cells at subconfluence and divided them into two sets. We first tested the "original" capability of FTIR imaging to identify these closely related cell lines on cells just dried on BaF2 slides. We then repeated the test after submitting the cells to the FFPE procedure. Our results show that the IR spectra of FFPE processed cancerous cell lines undergo small but significant changes due to the treatment. The spectral modifications were interpreted as a potential decrease in the phospholipid content and protein denaturation, in line with the scientific literature on the topic. Nevertheless, unsupervised analyses showed that spectral proximities and distances between closely related cell lines were mostly, but not entirely, conserved after FFPE processing. Finally, PLS-DA statistical analyses highlighted that closely related cell lines are still successfully identified and efficiently distinguished by FTIR spectroscopy after FFPE treatment. This last result paves the way towards identification and characterization of cellular subtypes on FFPE tissue sections by FTIR imaging, indicating that this analysis technique could become a potential useful tool in cancer research., Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published