ABSTRACT
Lymph node mapping has become an integral part of the management of melanoma and breast cancer with regard to both staging and treatment. We report our technique for lymphatic mapping and intraoperative lymphoscintigraphy applied to a patient with penile melanoma. This technique may improve the sensitivity of identifying the sentinel lymph node in patients with malignant penile lesions.
Subject(s)
Lymph Nodes/diagnostic imaging , Melanoma/diagnostic imaging , Penile Neoplasms/diagnostic imaging , Urethral Neoplasms/diagnostic imaging , Aged , Humans , Lymph Node Excision , Lymph Nodes/pathology , Male , Melanoma/pathology , Melanoma/surgery , Monitoring, Intraoperative , Neoplasm Staging , Penile Neoplasms/pathology , Penile Neoplasms/surgery , Radionuclide Imaging , Sensitivity and Specificity , Urethral Neoplasms/pathology , Urethral Neoplasms/surgeryABSTRACT
Extensive primary tumors and locally recurrent tumors of the pelvis or perineum are difficult to manage. We describe the techniques necessary to perform total pelvic exenteration with en bloc resection of the perineum and genitalia for treatment of recurrent sarcoma of the perineum. Wide excision of the sarcoma with negative margins can be achieved by resecting the inferior portion of the pubic symphysis. An absorbable mesh sling may be used to suspend the small bowel above the pelvis, facilitating postoperative radiation. A catheterizable continent urinary reservoir avoids the necessity of two stomas and improves quality of life. Adequate tissue coverage can be attained by myocutaneous gracilis flaps that promote wound healing.
