technetium-tc-99m-sulfur-colloid and Vaginal-Neoplasms

To determine the patterns of lymphatic drainage from primary vaginal cancers utilizing lymphoscintigraphy and to determine if this clinical information would affect treatment planning.. For women with newly diagnosed vaginal cancer, pretreatment lymphatic mapping and sentinel lymph node identification were performed using lymphoscintigraphy. In patients who underwent surgery, sentinel lymph nodes were identified intraoperatively using radiocolloid and patent blue dye. The impact of pretreatment lymphoscintigraphy findings on radiation planning in women who received radiation as initial treatment was noted.. Fourteen women were enrolled during the study period. At least 1 sentinel lymph node was identified on pretreatment lymphoscintigraphy in 11 patients (79%). The median number of sentinel nodes found per patient was 2, and bilateral sentinel nodes were found in 6 (55%) of the 11 patients with sentinel nodes identified. Among these 11 patients, 5 (45%) had sentinel nodes identified in the groin only, 4 (36%) had sentinel nodes identified in the pelvis only, and 2 (18%) had sentinel nodes identified in both the groin and the pelvis. No relationship was observed between sentinel lymph node location and primary tumor histologic subtype or location. Three (33%) of the 9 women treated initially with radiation therapy had their radiation field altered as a result of the lymphoscintigraphy findings.. In women with vaginal cancer, lymphatic drainage from the primary lesion does not always follow the lymphatic channels that would have been predicted anatomically. The addition of lymphoscintigraphy to the pretreatment evaluation for women with vaginal cancer may significantly improve comprehensive treatment planning.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Melanoma; Middle Aged; Pelvis; Predictive Value of Tests; Radionuclide Imaging; Retrospective Studies; Sensitivity and Specificity; Sentinel Lymph Node Biopsy; Technetium Tc 99m Sulfur Colloid; Vaginal Neoplasms

A 45-year-old woman with vaginal melanoma underwent Tc-99m sulfur colloid (filtered) lymphoscintigraphy with the acquisition of planar and SPECT/CT images for localization of a sentinel node before surgery. The study identified both inguinal and perirectal sentinel nodes, which proved beneficial in mapping potential anatomic spread of disease for staging and therapy planning. These results provide evidence for the use of routine SPECT/CT imaging for pelvic lymphoscintigraphic studies or as an adjunct tool for localizing sentinel nodes in cases that would not be demonstrated with planar imaging alone.

Topics: Female; Humans; Lymphatic Metastasis; Melanoma; Middle Aged; Radiopharmaceuticals; Technetium Tc 99m Sulfur Colloid; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Vaginal Neoplasms