title: The use of selective lymphadenectomy in squamous cell carcinoma of the wrist: a case report.
abstract: Squamous cell carcinoma is the second most common skin cancer in humans and has a rate of metastasis of 0.5%-5.9%. Regional lymphadenectomy is generally not recommended for patients with advanced lesions and clinically node-negative disease. Selective lymphadenectomy using preoperative lymphoscintigraphy and intraoperative radiolymphoscintigraphy and vital dye injections to identify the sentinel lymph node may help in staging patients with upper-extremity squamous cell carcinoma while avoiding the complications of a complete axillary node dissection. The case of a patient with a large squamous cell carcinoma of the wrist with clinically negative findings on axillary examination who was found to have a sentinel lymph node containing metastatic tumor is presented. Although this treatment method is still considered investigational, it holds great promise for nodal staging by being able to detect occult metastatic nodal disease in otherwise clinically node-negative patients.
authors.affiliation: Department of Surgery, University of Louisville School of Medicine, KY, USA.
authors.forename: W K
authors.initials: WK
authors.lastname: Stadelmann
authors.forename: S
authors.initials: S
authors.lastname: Javaheri
authors.forename: C W
authors.initials: CW
authors.lastname: Cruse
authors.forename: D S
authors.initials: DS
authors.lastname: Reintgen
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis; D011877:Radionuclide Imaging; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D014953:Wrist