Scintigraphic lymph node mapping in malignant vulvar melanoma

ABSTRACT

Nodal status is an important prognosticating factor in patients with melanoma. Metastasis to the lymph nodes would affect surgical treatment plan. Sentinel node mapping, otherwise known as lymphoscintigraphy, has become an integral part in the management of melanoma. This is a case report of the use of scintigraphic lymph node mapping in a patient with a very rare case of vulvar melanoma. The protocols and principles utilized in routine lymph node mapping have been applied in this case. The patient's lymphoscintigraphy revealed unilateral nodal drainage to the left, probably, corresponding to the obturator or internal and external iliac chains. This guided the attending physician to perform unilateral, left-sided nodal dissection only, as opposed to the usual bilateral nodal dissection. Thus, the possibility for post-operative morbidity was greatly minimized in this patient.