Update on radioguided surgery: from international consensus on sentinel node in head and neck cancer to the advances on gynaecological tumors and localization of non-palpable lesions

The aim of this review is to provide an updated perspective on different fields of radioguided surgery. With reference to the sentinel lymph node biopsy in oral squamous cell carcinoma, we present the results of the interactive debate held at the recent Congress of our specialty about the more relevant aspects of the London Consensus. Drainage peculiarities and indications according to the current guidelines on gynaecological tumours, endometrial and cervical cancer, are detailed and new scenarios for nuclear medicine physicians are presented; robotic surgery and hybrid tracers, for instance. Moreover, the notable growth in radioguided surgery indications for non-palpable lesions, widely used in mammary pathology, make it advisable to update two procedures which have shown satisfying results, such as the solitary pulmonary nodule and the osteoid osteoma.

Sarcoidosis mimicking metastatic gynaecological malignancies: a diagnostic and therapeutic challenge?

Several case reports describing the coexistence of sarcoidosis and malignancy have been published. Therefore, sarcoidosis should always be considered as a differential diagnosis when a cancer patient develops lymphadenopathy. Positron-emission tomography (PET) 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) combined with computed tomography (CT) is widely used for cancer staging and surveillance because it permits localization of metabolically active malignant tissue. PET/CT or CT findings in patients with suspected cancer recurrence can be used to guide early and aggressive therapy. However, benign hypermetabolic lymphadenopathy can mimic malignant lymphadenopathy, both on a conventional CT scan and on PET/CT. Thus, it is important to obtain a histological diagnosis before initiating antineoplastic therapy based on imaging findings. Four cases of patients affected by gynaecological malignancies and coexisting sarcoidosis are reported in this study. Furthermore, the clinical relevance of making a differential diagnosis between gynaecological cancer recurrence and granulomatous disorder is given specific mention.