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Sentinel Node Mapping in Melanoma of the Back: SPECT/CT Helps Discriminate "True" and "False" in-Transit Lymph Nodes
Valerio Duce1, Gianpiero Manca, Sara Mazzarri
1From the *Regional Center of Nuclear Medicine, University of Pisa Medical School; †Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Pisa; ‡Department of Nuclear Medicine, Santa Maria della Misericordia Hospital, Rovigo, Italy; and §Department of Radiology, University of Southern California, Los Angeles, CA.
Abstract:
A 32-year-old man with melanoma on the right paramedian region of the lower back underwent lymphoscintigraphy for radioguided sentinel node (SN) biopsy. Planar imaging showed the presence of 2 sites of radioactivity accumulation corresponding to an axillary SN and to an "in-transit" SN, located on the right side of the upper trunk. A further "hot spot" placed on the left paramedian region of the lower back was identified by planar lymphoscintigraphy. This last finding could be mistaken for another "in-transit" SN, but SPECT/CT demonstrated it was actually a nonspecific radiopharmaceutical accumulation at the level of the right renal pelvis.
