O’Toole et al 2000 — Aberrant Sentinel Nodes in Malignant Melanoma
Conceptual mismatch flagged by the author — read this before citing
This paper’s definition of “aberrant” is not what our case describes. Confirmed from the Methods section: “The sentinel node was considered to be aberrant if it was found outside a recognised lymphatic basin, in a subcutaneous or intra-muscular location. A sentinel node in the supraclavicular fossa, popliteal fossa or epitrochlear region was therefore not considered aberrant, as these are recognised lymphatic basins.” By this definition, a node found in the axilla — ipsilateral or contralateral — would never be classed as aberrant, because the axilla is itself a recognised basin. Our case has an aberrant lymphatic pathway (crossing to the contralateral side) reaching a completely normal, expected-type node (axilla) — the opposite emphasis from this paper, which is about node location aberrance (nodes turning up outside any recognised basin — e.g. lateral chest wall, flank, deltopectoral groove) regardless of which side of the body they’re on.
What the paper actually found (100 consecutive melanoma SLNB patients, 1997–1999)
3/100 patients had a sentinel node outside a recognised basin (lateral chest wall, right flank, left deltopectoral groove) — 2 were trunk primaries, 1 upper limb. In each case, a node within a recognised basin was also identified. No contralateral axillary drainage is described in either case.
My take
Don’t cite this as support for our case’s aberrant-pathway claim — it would be a category error a sharp reviewer would catch. It’s still useful, narrowly, as a terminology contrast: worth one sentence in the Discussion explicitly distinguishing “aberrant sentinel node location” (this paper’s subject) from “aberrant lymphatic pathway to a normally-located node” (our case), so the manuscript pre-empts any confusion between the two concepts.