title: The added value of a portable gamma camera for intraoperative detection of sentinel lymph node in squamous cell carcinoma of the oral cavity: A case report.
abstract: The use of sentinel lymph node biopsy in squamous cell carcinoma of the oral cavity is still subject to debate although some studies have reported its feasibility. The main reason for this debate is probably due to the high false-negative rate for floor-of-mouth tumors per se. We report the case of a 54-year-old man with a T1N0 floor-of-mouth squamous cell carcinoma who underwent the sentinel lymph node procedure. Lymphoscintigraphy and SPECT/CT imaging were performed for lymphatic mapping with a conventional gamma camera. Sentinel lymph nodes were identified at right Ib, left IIa and Ia levels. However, these sentinel lymph nodes were difficult to detect intraoperatively with a gamma probe owing to the activity originating from the injection site. The use of a portable gamma camera made it possible to localize and excise all the sentinel lymph nodes. This case demonstrates the usefulness of this tool to improve sentinel lymph node detecting in floor-of-mouth tumors, especially those close to the injection area.
authors.affiliation: Department of Nuclear Medicine, Hospital Clinic, Barcelona, Spain. Electronic address: mmayoral@clinic.ub.es.
authors.forename: M
authors.initials: M
authors.lastname: Mayoral
authors.affiliation: Department of Nuclear Medicine, Hospital Clinic, Barcelona, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Paredes
authors.affiliation: Department of Maxillofacial Surgery, Hospital Clinic, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Sieira
authors.affiliation: Department of Nuclear Medicine, Hospital Clinic, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Vidal-Sicart
authors.affiliation: Department of Maxillofacial Surgery, Hospital Clinic, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Marti
authors.affiliation: Department of Nuclear Medicine, Hospital Clinic, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Pons
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D015902:Gamma Cameras; D006801:Humans; D007430:Intraoperative Care / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D011877:Radionuclide Imaging; D021701:Sentinel Lymph Node Biopsy / Q000295:instrumentation*
keywords: Carcinoma escamoso; Floor-of-mouth tumors; Gammacámara portátil; Ganglio centinela; Oral cavity tumors; Portable gamma camera; Sentinel lymph node; Squamous cell carcinoma; Tumores de la cavidad oral; Tumores del suelo de la boca