Discordant lymphatic drainage patterns revealed by serial lymphoscintigraphy in cutaneous head and neck malignancies

Abstract

Head and neck lymphatic drainage patterns not only vary between patients but also can vary with time for a single patient.

The impact of 18F-FDG PET-CT scanning for staging and management of Merkel cell carcinoma: Results from Westmead Hospital, Sydney, Australia

“…25 Because of the variable lymphatic drainage in cutaneous malignancies, radiotracer or dye is required to identify the sentinel lymph node (SLN), but this technique does not identify 100% of SLNs and results of lymphoscintigraphy can vary with time for individuals. 26 The optimal imaging studies for patients with MCC remain unclear. The advent of SLNB using lymphoscintigraphy has allowed easier pathological staging than with the traditional elective lymph node dissection, which has an associated morbidity, particularly in an elderly population.…”

Accuracy and Reproducibility of Lymphoscintigraphy for Sentinel Node Detection in Patients with Cutaneous Melanoma

“…On the other hand, a hot spot does not always represent a lymph node but can be caused by accidental spillage from the injection site or a drop of radiotracer, as well as the well-known occurrence of lymphatic lakes. Following the procedure meticulously during lymphoscintigraphy is mandatory for best results (16,18,19).…”

Ganglion sentinelle dans les mélanomes cutanés de l’extrémité cervicocéphalique

“…Nouveau standard pour certains [3], rétablie comme option dans la dernière mise au point de [7], après deux scintigraphies à 24 heures d'intervalle chez des patients traités pour un mélanome ou une tumeur de Merkel de la tête, notaient une discordance entre les deux examens de 32 % ! Afin de pallier à cette grande variabilité, certains auteurs comme Teltzrow et al [8] argumentent ainsi le curage systématique après biopsie du ganglion sentinelle.…”