New applications of radioguided surgery in oncology.
OBJECTIVE
To report oncological cases (excluding those related to breast cancer) for which radioguided surgery has been used in combination with the Radioguided Occult Lesion Localization technique.


BACKGROUND
Radioguided surgery enables a surgeon to identify lesions or tissues that have been preoperatively marked with radioactive substances. The Radioguided Occult Lesion Localization technique has been widely used to identify the sentinel lymph node and occult lesions in patients with breast cancer. However, few studies have reported the use of this technique for non-breast cancer pathologies.


METHODS
In all cases, injection of Technecium-99m sulfur colloid was performed, directly inside or near by the suspicious lesion, guided by ultrasound or computed tomography, up to 36 hours prior to the surgical procedure. Intraoperative lesion detection was carried out using a gamma-probe.


RESULTS
We report five oncology cases in which preoperative markings of the lesions were carried out using the Radioguided Occult Lesion Localization technique. The patients presented with the following: recurrence of renal cell carcinoma, cervical recurrence of papillary carcinoma of the thyroid, recurrence of retroperitoneal sarcoma, lesions of the popliteal fossa, and recurrence of rhabdomyosarcoma of a thigh. In each case, the lesions that were marked preoperatively were ultimately successfully excised.


CONCLUSIONS
Radioguided surgery has proven to be a safe and effective alternative for the management of oncology patients. The Radioguided Occult Lesion Localization technique can be useful in selected cases where suspect lesions may be difficult to identify intraoperatively, due to their dimensions or anatomical location. The procedure allows for more conservative excisions and reduces the surgery-related morbidity.
Bitencourt
Almir Galvão Vieira
AG
Department of Image, Hospital AC Camargo, São Paulo, SP, Brazil. almirgvb@yahoo.com.br
Lima
Eduardo Nóbrega Pereira
EN
Pinto
Paula Nicole Vieira
PN
Martins
Eduardo Bruno Lobato
EB
Chojniak
Rubens
R
D000293:Adolescent; D000328:Adult; D005260:Female; D005720:Gamma Rays; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013671:Technetium Tc 99m Sulfur Colloid; D018084:Ultrasonography, Interventional
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid