Anais Brasileiros de Dermatologia
On-line version ISSN 1806-4841
SAPIENZA, Marcelo T. et al. The role of sentinel node mapping in malignant melanoma: experience with 99mTc-phytate and a review of the literature. An. Bras. Dermatol. [online]. 2004, vol.79, n.2, pp. 181-191. ISSN 1806-4841. http://dx.doi.org/10.1590/S0365-05962004000200006.
BACKGROUND: Sentinel lymph node (SLN), corresponding to the first lymph node draining the tumor, is usually the first one to receive its metastasis, and its biopsy is used to define the status of the whole lymphatic basin. OBJECTIVE: The aim of this paper is to describe the use 99mTc-Fitato in SLN localization in malignant melanoma patients, and to review the main indications and information provided by SLN biopsy. METHOD: A total of 92 patients with malignant melanoma was studied. Lymph node scintigraphy was carried out after the subdermal injection of 99mTc-Phytate. After 18-24 hours, intra-operative SLN localization was carried out using the gamma-probe and lymph node dissection was then performed. RESULTS: Lymphoscintigraphy identified the sentinel node in all studies and intra-operative detection using gamma-probe was reached in 98.8% of the cases. The SLN was involved in 23 patients (26%). The method's negative predictive value was 100%, and there were no side effects related to 99mTc-Phytate. CONCLUSION: Scintigraphic and intra-operative sentinel node detection was satisfactorily performed using 99mTc-Phytate, an easily available and low cost radiopharmaceutical. SLN mapping allows the use of more accurate tumor staging techniques and reduces surgical morbidity.
Keywords : sentinel lymph biopsy; radionuclide imaging; melanoma.