Sentinel lymph node biopsy in parotid gland carcinoma.
Indications for elective neck dissection (ELND) and its extent in N0-staged patients with parotid gland carcinoma are inconsistent. Therefore, a pilot study was performed to test the feasibility and efficacy of radioguided sentinel lymph node biopsy (SLNB) in these tumors. A total of 6 patients underwent lymphoscintigraphy, SLNB, and level II-IV ELND. In 2 patients, the latter was extended to level V because the scans had revealed an additional sentinel lymph node (SLN) in this atypical nodal region. In all cases, the SLNs were detected intraoperatively. The SLNB exactly reflected the positive and negative histopathologic status of the remaining lymphatic basin in patients 1 and 4, respectively. One case of false negativity of SLNB could be explained by distortion of the lymphatic outflow resulting from intraparotid localization of lymphatic metastasis. The authors believe that the SLNB could provide reliable information on the status of regional lymph nodes, making it possible to base the neck dissection on the actual presence of the micrometastases and to detect metastatic tumors at unusual nodal levels.
ORL Clinic, Faculty Hospital, Palacký University Olomouc, Charles University Prague, Czech Republic. stareki@fnol.cz
Ivo
I
Stárek
Pavel
P
Koranda
Vítĕzslav
V
Zboøil
Lubor
L
Mrzena
D006801:Humans; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging / Q000473:pathology; D037981:Neck Dissection; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D010865:Pilot Projects; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin
D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid