A Case of Nasal Merkel Cell Carcinoma Draining to a Buccinator Sentinel Lymph Node.
A 73-year-old man diagnosed with Merkel cell carcinoma of the left nasal ala was referred for preoperative scintigraphic sentinel lymph node mapping. In three separate foci around the lesion, 0.2 mCi of Tc-sulfur colloid was intradermally administered. Planar images demonstrated accumulation of tracer midway between the nose and left ear. SPECT/CT images localized radiotracer uptake to the left buccinator/buccal space, consistent with a buccinator lymph node, which is an inconsistent part of the facial lymphatic drainage. This case illustrates the added value of SPECT/CT and 3D reconstruction in sentinel lymph node localization, particularly in the head and neck.
From the *Department of Radiology, Division of Nuclear Medicine, and †Department of Radiology, University of Washington, Seattle, WA.
Mohammed S
MS
Bermo
Alan
A
Leung
Fatemeh
F
Behnia
D000368:Aged; D015266:Carcinoma, Merkel Cell / Q000000981:diagnostic imaging*; D002610:Cheek; D006801:Humans; D021621:Imaging, Three-Dimensional; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008297:Male; D009669:Nose Neoplasms / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D000071036:Sentinel Lymph Node / Q000000981:diagnostic imaging*; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D012878:Skin Neoplasms / Q000000981:diagnostic imaging*; D013671:Technetium Tc 99m Sulfur Colloid
D019275:Radiopharmaceuticals; D013671:Technetium Tc 99m Sulfur Colloid