Preoperative evaluation of sentinel lymph node status in melanoma by means of (99m)Tc-MIBI and lymphoscintigraphy: a case report

Previous reports have shown that (99m)Tc-sestamibi (MIBI) could detect clinically occult metastatic melanoma lesions. This article reports on a patient with invasive melanoma of the right heel in whom the sentinel node status was preoperatively evaluated with this tracer. Although regional lymph nodes were clinically negative, (99m)Tc-MIBI scintigraphy showed focal increased tracer uptake in the right groin that corresponded to the location of 2 sentinel nodes visualized by lymphoscintigraphy with (99m)Tc-colloidal rhenium sulfide performed the same day. A gamma-probe was used intraoperatively to guide the excision of the sentinel nodes that were further classified as metastatic by histopathology. This double-technique approach is technically feasible and has the potential of selecting a group of patients who might benefit from a selective complete lymphadenectomy.

Scintigraphic evaluation of malignant melanoma lesions with Tc-99m tetrofosmin

Two cases of malignant melanoma (primary and metastatic lesions) imaged with Tc-99m tetrofosmin are reported. One patient showed intense uptake in a primary skin lesion of the thorax, and the other patient had accumulation in skin, cerebellum, breast, and lymph node metastases. Like Tc-99m MIBI, Tc-99m tetrofosmin imaging may be of clinical relevance in the evaluation of suspicious skin lesions and in patients with known cutaneous malignant melanoma in the assessment of recurrent disease during follow-up evaluation.

Scintigraphic detection of invasive cutaneous malignant melanoma with Tc-99m MIBI

Malignant melanoma is a relatively uncommon cancer of increasing incidence. The authors report on two cases of malignant melanoma lesions (primary and lymph node metastasis) imaged with Tc-99m MIBI. One patient revealed intense accumulation of the radiotracer in a primary skin lesion of the thorax, whereas the other patient showed increased Tc-99m MIBI uptake in a lymph node metastasis of the neck. Tc-99m MIBI imaging could be helpful in the evaluation of patients with suspicious skin lesions and in patients with known cutaneous malignant melanoma, in the investigation of lymph nodal invasion, local recurrence, and metastatic spread.