Combined use of intraoperative lymphatic mapping and lymphoscintigraphy in the management of squamous cell cancer of the vulva.
BACKGROUND
The standard care of the patient with squamous cell cancer of the vulva is radical vulvectomy along with inguinal-femoral node dissection. We explored the feasibility of sentinel lymphadenectomy in patients with squamous cell cancer of the vulva.


METHODS
Patients with biopsy proven squamous cell cancer of the vulva were studied with preoperative lymphoscintigraphy, intraoperative lymphatic mapping with isosulfan blue combined with intraoperative lymphoscintigraphy utilizing a hand-held gamma counter.


RESULTS
Five patients with invasive squamous cell cancer were studied. Sentinel nodes were identified in six lymphatic basins. One lymphatic basins had two sentinel nodes. Six of seven sentinel nodes were blue and all retained radioactivity at a ratio of at least 3:1 above the background levels in the regional node basin. One patient was found to have metastatic tumor which was confined to a sentinel lymph node. There was minimal morbidity associated with the procedure.


CONCLUSIONS
Lymphatic mapping is feasible in patients with squamous cell cancer of the vulva. These initial results suggests further study is warranted.
Department of Obstetrics and Gynecology, University of Hawaii School of Medicine, Honolulu 96813, USA.
K Y
KY
Terada
M N
MN
Coel
P
P
Ko
J H
JH
Wong
D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008207:Lymphatic Metastasis; D011877:Radionuclide Imaging; D014846:Vulvar Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*