Sentinel Lymph Node Mapping with Radiocolloid in Malign Melanoma: Significance of Histopathological Findings in Follow up

Abstract

The presence of metastasis in regional lymph nodes has an essential value on survival in patients with malign melanoma. This study aimed to evaluate our experience on sentinel lymph node (SLN) mapping with radiocolloid in malign melanoma patients using SPECT/CT and present follow-up findings. Conventional planar lymphoscintigraphy and SPECT/CT images of 66 patients with primary cutaneous melanoma who underwent SLN biopsy in addition to the local primary excision or reexcision were retrospectively reviewed. All detected lymph nodes were removed and evaluated histopathologically. The number and histopathological findings of SLNs were determined, and follow-up findings of patients with metastatic or nonmetastatic nodes were comparedA statistically significant difference was not found in the number of detected SLN between planar and SPECT/CT imaging. The difference of total numbers of the metastatic and benign lymph nodes was statistically significant. A total of 55/66 patients were followed up with 10 months of median follow-up time and the presence of metastatic SLN on initial histopathological assessment was found to have a high risk for further metastatic disease. In the follow-up findings of 8/10 patients in whom SLN could not be detected on both planar and SPECT/CT imaging could be reached, normal findings were detected in 4 patients, and common nodal-visceral metastases in 4 patients. We concluded that, patients with malignant SLN histopathology had a high risk of developing metastases and should be followed up more frequently. As determined high metastases rate in patients with non-visualized SLN on radiocolloid imaging, it is essential to follow up also these patients meticulously.

Keywords

• Malign melanoma
• lymphoscintigraphy
• radiocolloid
• SPECT/CT

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