Related Experiment Video
Updated: Jan 3, 2026
Lateral Molar Approach-Driven Transoral Endoscopic Procedure for Benign Infratemporal Fossa Tumor Resection
Published on: August 15, 2025
A Case of Nasal Merkel Cell Carcinoma Draining to a Buccinator Sentinel Lymph Node
Mohammed S Bermo1, Alan Leung, Fatemeh Behnia
1From the *Department of Radiology, Division of Nuclear Medicine, and †Department of Radiology, University of Washington, Seattle, WA.
Abstract:
A 73-year-old man diagnosed with Merkel cell carcinoma of the left nasal ala was referred for preoperative scintigraphic sentinel lymph node mapping. In three separate foci around the lesion, 0.2 mCi of Tc-sulfur colloid was intradermally administered. Planar images demonstrated accumulation of tracer midway between the nose and left ear. SPECT/CT images localized radiotracer uptake to the left buccinator/buccal space, consistent with a buccinator lymph node, which is an inconsistent part of the facial lymphatic drainage. This case illustrates the added value of SPECT/CT and 3D reconstruction in sentinel lymph node localization, particularly in the head and neck.
Insights
Sentinel lymph node mapping for Merkel cell carcinoma is enhanced by SPECT/CT. This advanced imaging precisely locates the sentinel node in the head and neck, improving surgical planning.
Area of Science:
- Nuclear medicine
- Oncology
- Head and neck surgery
Background:
- Merkel cell carcinoma is a rare but aggressive skin cancer.
- Sentinel lymph node biopsy is crucial for staging head and neck cancers.
- Accurate lymph node localization is essential for effective treatment planning.
Observation:
- A 73-year-old man with Merkel cell carcinoma of the nasal ala underwent sentinel lymph node mapping.
- Technetium-99m sulfur colloid was injected intradermally around the tumor.
- Initial planar imaging showed tracer accumulation between the nose and ear.
Findings:
- SPECT/CT imaging precisely localized radiotracer uptake to the left buccinator/buccal space.
- This identified an unusual but consistent buccinator lymph node.
- SPECT/CT and 3D reconstruction significantly improved sentinel lymph node localization.
Implications:
- SPECT/CT offers superior precision for sentinel lymph node mapping in head and neck oncology.
- This technique aids in identifying non-traditional lymphatic drainage pathways.
- Enhanced localization improves the accuracy of staging and treatment for Merkel cell carcinoma.
More Related Videos
07:51The Application of 1% Methylene Blue Dye As a Single Technique in Breast Cancer Sentinel Node Biopsy
Published on: June 1, 2019
07:29Intramucosal Inoculation of Squamous Cell Carcinoma Cells in Mice for Tumor Immune Profiling and Treatment Response Assessment
Published on: April 22, 2019