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Preoperative Evaluation of Sentinel Lymph Node Status in Melanoma by Means of ^99mTc-MIBI and Lymphoscintigraphy: A Case Report

Nuclear Medicine Center and Department of Dermatology, Clinical Hospital of the University of Uruguay, Montevideo; and National Institute of Oncology, Montevideo, Uruguay

Previous reports have shown that ^99mTc-sestamibi (MIBI) could detect clinically occult metastatic melanoma lesions. This article reports on a patient with invasive melanoma of the right heel in whom the sentinel node status was preoperatively evaluated with this tracer. Although regional lymph nodes were clinically negative, ^99mTc-MIBI scintigraphy showed focal increased tracer uptake in the right groin that corresponded to the location of 2 sentinel nodes visualized by lymphoscintigraphy with ^99mTc-colloidal rhenium sulfide performed the same day. A -probe was used intraoperatively to guide the excision of the sentinel nodes that were further classified as metastatic by histopathology. This double-technique approach is technically feasible and has the potential of selecting a group of patients who might benefit from a selective complete lymphadenectomy.

Key Words: lymphoscintigraphy; melanoma; sentinel lymph nodes; ^99mTc-MIBI