Related Experiment Videos
Sentinel lymph node detection by lymphoscintigraphy in malignant melanoma
M G Caprio1, G Carbone, A Bracigliano
1Department of Nuclear Medicine, University of Naples Federico II, Italy.
Tumori
|October 9, 2002
Summary
Sentinel lymph node (SLN) detection using scintigraphy is effective for malignant melanoma (MM) patients, aiding in surgical planning and potentially avoiding unnecessary dissections. This method accurately identifies drainage pathways, especially for trunk lesions where dual drainage is common.
Area of Science:
- Oncology
- Nuclear Medicine
- Surgical Pathology
Background:
- Sentinel lymph node (SLN) detection is crucial in malignant melanoma (MM) management to prevent extensive lymph node dissection.
- Accurate SLN identification guides surgical decisions and staging.
Purpose of the Study:
- To evaluate the utility of scintigraphic SLN detection in patients diagnosed with malignant melanoma.
- To assess the accuracy and implications of SLN identification in MM staging and treatment planning.
Main Methods:
- A study involving 241 patients with MM, where approximately 10 MBq of 99mTc Nanocoll was intradermally injected around the MM lesion or surgical scar.
- Dynamic scintigraphic acquisition was performed for 20 minutes, with SLNs marked using an external radioactive marker and China ink.
- Histology and immunohistochemistry were used to diagnose MM in excised SLNs.
Main Results:
- 294 SLNs were identified across various anatomical regions, with drainage detected in most patients.
- Multiple SLNs were identified in 43 patients, and 13 patients with trunk lesions showed drainage to unexpected or multiple lymph node stations.
- Metastatic MM was diagnosed in 25 SLNs, with 9 cases showing further nodal involvement. Only one patient developed metastatic disease during follow-up after a histologically negative SLN.
Conclusions:
- Scintigraphic SLN detection is a valuable tool for MM patients, improving the evaluation of unpredictable lymphatic drainage, particularly for trunk lesions.
- The technique identified dual drainage in approximately 10% of cases, mainly from trunk lesions, highlighting its importance in surgical planning.
- Further studies are planned to compare follow-up results with a control group to establish the prognostic value of lymphoscintigraphy in MM.