[Detection of lymphatic metastasis from malignant melanoma after identification of the sentinel node by preoperative lymphoscintigraphy and intraoperative radioisotopic detection].

Abstract

OBJECTIVES:

The aim of this study was to evaluate the detection of the first lymph node draining the primary tumour site, using a radioisotopic mapping alone and to determine whether a preoperative lymphoscintigraphy using technetium sulfur colloid and a hand-held gamma detecting probe could improve the detection of the sentinel lymph node (SLN) in melanoma.

PATIENTS AND METHOD:

From January to December 1998, 36 patients with a cutaneous melanoma larger than 0.75 mm, stage I TNM were included in this prospective study. Mean Breslow was 1.85 mm. The distribution of melanoma was head and neck (n = 9), trunk (n = 7), upper extremities (n = 4), lower extremities (n = 16). Preoperative lymphoscintigram and intraoperative detection were used. The first hot lymph node was supposed to be the SLN.

RESULTS:

In all cases, a lymph node was found and nine patients had more than one SLN (average number of SLN per patient: 1.25). Aberrant drainages were found in seven patients (19.4%): 1 in-transit lymph node, three paradoxical bassins, three bypasses). Four out of 36 patients had lymph node metastases and underwent elective lymph node dissection.

CONCLUSION:

The radio-isotopic technique used alone for the identification of the SLN is efficient in melanoma with a 100% detection rate in this short series.

• Authors: O Tiffet, J L Perrot, C Soler, F Cambazard, F Dubois, P Seguin, J Cuilleret
• Journal: Annales de chirurgie (Ann Chir) Vol. 125 Issue 1 Pg. 32-9 (Jan 2000) ISSN: 0003-3944 [Print] France
• Vernacular Title: Recherche des métastases ganglionnaires des mélanomes malins après isolement du ganglion sentinelle par lymphoscintigraphie préopératoire et détection radio-isotopique peropératoire. Résultats préliminaires.
• PMID: 10921182 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Radiopharmaceuticals
• Technetium Tc 99m Sulfur Colloid

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Humans
• Lymph Nodes (diagnostic imaging)
• Lymphatic Metastasis (diagnostic imaging)
• Male
• Melanoma (secondary, surgery)
• Middle Aged
• Preoperative Care
• Radionuclide Imaging
• Radiopharmaceuticals
• Sensitivity and Specificity
• Skin Neoplasms (pathology, surgery)
• Technetium Tc 99m Sulfur Colloid