Management of Acral Melanoma: Value of Sentinel Lymph Node Biopsy at Avicenne University Hospital — A Case Series of Five Patients

Acral melanoma is a rare but aggressive form of skin cancer, typically located on the palms, soles, or periungual regions. It carries a poor prognosis, particularly in North Africa, where diagnosis is often delayed. Sentinel lymph node biopsy (SLNB) is currently recommended for staging high-risk or thick melanomas, yet its specific role in managing acral melanoma remains underreported in Morocco. This retrospective descriptive study was conducted at CHU Avicenne between January 2020 and June 2024 and included five patients with histologically confirmed acral melanoma who underwent SLNB according to international guidelines. Clinical and histological parameters, sentinel lymph node status, and patient outcomes were analyzed. The average age was 61.2 years, with a mean diagnostic delay of 7.2 months. The sentinel lymph node was positive in 40% of cases, all involving thick and ulcerated tumors. In all positive cases, management was modified to include lymph node dissection and adjuvant immunotherapy. No deaths were observed during a median follow-up of 24 months. This case series highlights the frequent nodal involvement in acral melanoma in Morocco and emphasizes the value of SLNB in improving patient management and prognosis.