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A worrying lump
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
A new surgical technique known as sentinel lymph node biopsy is currently being evaluated. This involves giving an injection of radioactive isotope and patent blue dye into the tissues around the primary tumour. This tracer is transported initially to the first node receiving lymph from this area – the sentinel node. This node can then be sampled and sent for histological analysis – hopefully a more reliable adjunct to staging than random axillary node sampling.
Breast Cancer: Surgical Perspectives
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
Patricia J. Eubanks, Hernan I. Vargas, Stanley R. Klein
Giuliano et al. report 95.6% accuracy in predicting axillary nodal status in 114 cases in which a sentinel node was identified (65% of the time) [54]. They noted a significant learning curve and subsequently found 100% predictability in the latter part of the study. Albertini et al. report the ability to locate the sentinel lymph node 92% of the time using Isosulfan Blue in combination with technetium-labeled sulfur colloid [55]. They found that all patients with positive axillary lymph nodes had positive sentinel nodes. The technique of sentinel lymph node mapping involves injecting the breast at the tumor site with Isosulfan Blue dye (and radiolabeled colloid). The radioactive colloid allows gamma probe assistance in locating the sentinel lymph node and enhances detection of the first nodal basin [56].
Rhabdomyosarcoma
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Gideon Sandler, Andrea Hayes-Jordan
These include tumors of the middle ear, mastoid, nasopharynx, nasal cavity, paranasal sinus, parapharyngeal, pterygopalatine, and infratemporal fossae. Those without involvement of the cerebrospinal fluid do not require whole brain irradiation. Sentinel lymph node biopsy may be beneficial for staging. Craniofacial resection should only occur if primary management fails.
Surgical Research Progress of Sentinel Lymph Node Biopsy in Melanoma
Published in Journal of Investigative Surgery, 2023
The malignant nature of melanoma is significant, and timely diagnosis and intervention can result in a favorable prognosis for the majority of early-stage patients (stage I and stage II). In recent decades, significant progress has been made in melanoma research, revolutionizing the treatment landscape for melanoma patients. Complete lymph node dissection, and even sentinel lymph node biopsy, are no longer obligatory choices. Novel localization and tracer techniques implemented in clinical practice have enhanced the efficiency and accuracy of sentinel lymph node biopsy. Furthermore, the emergence of gene testing, targeted drugs, immunotherapy, and other cutting-edge technologies has paved the way for a multidisciplinary combined treatment model. This model integrates surgical intervention with adjuvant therapy, making it a prominent approach in melanoma treatment, instilling new hope in melanoma patients [52,53].
Comprehensive Assessment of ERα, PR, Ki67, P53 to Predict the Risk of Lymph Node Metastasis in Low-Risk Endometrial Cancer
Published in Journal of Investigative Surgery, 2023
Yuzhen Huang, Peng Jiang, Wei Kong, Yuan Tu, Ning Li, Jinyu Wang, Qian Zhou, Rui Yuan
Endometrial cancer is a common malignant cancer in women, especially for perimenopausal and postmenopausal women. The incidence of endometrial cancer is growing in both developed and underdeveloped regions. With changes in fertility concept and economic development, the incidence in East Asia and South Asia showed a rapid growth trend [1]. According to the recommendations of the international guidelines [2], low-risk patients (low- and medium-grade endometrial cancer, without deep muscle infiltration, which means infiltration depth was less than 1/2, or cervical stromal infiltration) usually did not undergo lymph node resection (including lymph node biopsy, pelvic lymph node dissection, and para-aortic lymph node dissection). However, lymph node metastasis had already occurred in some of these patients [3]. Biopsy of sentinel lymph node has been generally proven to be effectual [4, 5], but its low sensitivity may lead to missing out some patients with lymph node metastasis [3]. The occurrence of lymph node metastasis without proper treatment will result in increasing risk of recurrence and poor prognosis. However, patients who had undergone lymph node resection (including lymph node biopsy, pelvic and para-aortic lymph node ressection) would probably have lower limb lymphedema [6], urinary incontinence [7], and other complications after surgery. Accurately determining whether a patient needs lymph node resection will strongly influence the survival and life quality of patient with endometrial cancer after surgery.
The impact of COVID-19 pandemics on dermatologic surgery: real-life data from the Italian Red-Zone
Published in Journal of Dermatological Treatment, 2022
Laura Cristina Gironi, Paolo Boggio, Roberto Giorgione, Elia Esposto, Vanessa Tarantino, Giovanni Damiani, Paola Savoia
According to the Crisis Unit declaration, we performed only surgical procedures of oncological relevance, life-saving surgical procedures, and diagnostic biopsies in lesion clinically ambiguous with a lethal disease in the differential diagnosis (i.e. pemphigus). We did not limit surgical procedures that routinely are performed in the SSU: (i) simple surgical excision (e.g. elliptical excision), (ii) complex skin surgery procedures (e.g. MOHS micrographic surgery and its variants), (iii) sentinel lymph node biopsy, or (iv) complex reconstruction techniques (grafts, flaps, etc.). Whenever possible (i.e. in case of small surgical excisions/biopsies), we used dissolvable stitches to avoid post-surgical control (19,20). We preferred primary instead of secondary intention healing, especially in the peri-ocular/oral/nasal areas, to avoid surgical wounds adjacent to the respiratory/ocular tract capable of increasing COVID-19 vulnerability (21). Facial sutures and dressings would compromise use of PPE were, if possible, avoided.