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Cutaneous Melanoma pp 1–33Cite as

Lymphoscintigraphy in Patients with Melanoma

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Abstract

Sentinel lymph node biopsy was first described in melanoma patients. The technique requires accurate location of the sentinel nodes using lymphatic mapping, and the surgical removal of only those nodes receiving direct lymphatic drainage from the primary tumor site. When careful histologic examination is added, unprecedented accuracy in staging the regional lymph nodes is achieved.

The important role of lymphoscintigraphy in this process is to reveal the precise lymphatic road map to the draining sentinel nodes (SN) in each patient, using radiolabeled tracers. The actual lymphatic collecting vessels can be followed on dynamic imaging until a sentinel node is reached. Only such sentinel nodes should be removed, and second-tier nodes that receive trace upstream should remain in place to avoid unnecessary surgical morbidity.

The use of lymphoscintigraphy in large numbers of melanoma patients has redefined the patterns of lymphatic drainage of the human skin with new drainage pathways described to unexpected node fields.

New hybrid SPECT/CT imaging provides the precise anatomical location of sentinel nodes, greatly aiding their surgical removal especially in the head and neck region and pelvis.

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Authors and Affiliations

  1. Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia

    Roger F. Uren, Omgo E. Nieweg & John F. Thompson

  2. Alfred Nuclear Medicine and Ultrasound, RPAH Medical Centre, Newtown, NSW, Australia

    Roger F. Uren

  3. Central Clinical Schools, The University of Sydney, Sydney, NSW, Australia

    Roger F. Uren, Omgo E. Nieweg & John F. Thompson

Authors
  1. Roger F. Uren
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  2. Omgo E. Nieweg
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  3. John F. Thompson
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Correspondence to Roger F. Uren .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA

    Charles Balch

  2. Division of Surgery, UT MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey Gershenwald

  3. Melanoma Institute of Australia, Wollstonecraft, Australia

    John Thompson

  4. Georgetown Medical Center, Washington, DC, USA

    Michael Atkins

  5. Melanoma and Skin Cancer Program, University of Pittsburgh, Pittsburgh, PA, USA

    John Kirkwood

  6. University of Sydney, Sydney, NSW, Australia

    Richard Kefford

  7. Department of Dermatology, Harvard Medical Center, Boston, MA, USA

    Arthur Sober

  8. Department of Dermatology, Memorial Sloan Kettering, New York, NY, USA

    Allan Halpern

  9. Department of Dermatology, University Hospital, Tübingen, Tübingen, Germany

    Claus Garbe

  10. Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Camperdown NSW, Australia

    Richard Scolyer

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Uren, R.F., Nieweg, O.E., Thompson, J.F. (2019). Lymphoscintigraphy in Patients with Melanoma. In: Balch, C., et al. Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-46029-1_19-1

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