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Lymphoscintigraphy in radical vaginal trachelectomy and pelvic lymphadenectomy
Dariusz Wydra1, Sambor Sawicki, Janusz Emerich
1Department of Gynaecology, Medical University, Gdańsk, Poland. dwydra@amg.gda.pl
Background:
Radical hysterectomy has traditionally been the treatment of choice for early invasive cervical carcinoma. Validation of the sentinel lymph node concept in gynaecology has led to less radical surgery. If preservation of fertility is an issue, then radical trachelectomy is an accepted approach.
Case Report:
A 29-year-old female presented with stage IB1 cervical cancer was treated by radical vaginal trachelectomy and pelvic lymphadenectomy as definitive treatment. Two obturator nodes visualised on lymphoscintigraphy and one parametrial not visualized on lymphoscintigraphy were "hot" and blue during surgery, and identified as sentinel nodes. All 18 nodes were non-metastatic.
Conclusion:
Preoperative lymphoscintigraphy is a useful tool in the preoperative localisation of sentinel lymph nodes, and should be undertaken in cases of early invasive cervical carcinoma where a radical trachelectomy is performed to preserve fertility.
