Lymphatic mapping with sentinel node biopsy in pediatric patients

Holly Neville, Richard J. Andrassy, Kevin P. Lally, Cyndy Corpron, Merrick I. Ross

Research output: Contribution to journalArticle

75 Citations (Scopus)

Abstract

Background/Purpose: Lymphatic mapping with sentinel node biopsy is used widely in adult melanoma and breast cancer to determine nodal status without the morbidity associated with elective lymph node dissection. This technique can be used in children to determine lymph node status with limited dissection and accurate interpretation. The authors report their initial experience. Methods: The charts of patients who underwent lymphatic mapping with sentinel node biopsy were reviewed retrospectively. Lymphoscintigraphy was performed in patients with truncal lesions 24 hours before surgery to determine the draining nodal basin (for surgical mapping). The tumors were injected 1 hour preoperatively with technetium sulfur colloid and in the operating room with Lymphazurin blue. The draining basin was examined using a radioisotope detector. The blue nodes with high counts were localized and removed. If nodal metastases were identified, lymph node dissection was recommended. Four patients were injected only with Lymphazurin blue. Results: Thirteen children (7 girls, 6 boys; mean age, 7 years) underwent lymphatic mapping with sentinel node biopsy. The tumor types were as follows: 8 malignant melanoma (6 extremity, 2 truncal), 1 malignant peripheral nerve sheath tumor, 1 alveolar soft part sarcoma, and 3 rhabdomyosarcoma. A mean of 2.4 nodes (range, 1 to 6) were removed from each patient. Six patients had a positive sentinel node. Formal lymph node dissection was performed on 4 of the 6 patients, 1 of whom had further nodal disease with 2 of 13 nodes containing micrometastases. One of the 6 patients refused lymph node dissection and adjuvant therapy; the final patient had rhabdomyosarcoma, a malignancy for which lymph node dissection is not indicated. Pulmonary metastasis developed 26 months after diagnoses in the patient with alveolar soft part sarcoma and a negative sentinel node. This patient was injected only with Lymphazurin blue at the time of sentinel node biopsy and refused adjuvant therapy. There have been no other recurrences. There were no complications related to lymphatic mapping or sentinel node biopsy. Conclusions: Lymphatic mapping with sentinel node biopsy, using both technetium-labeled sulfur colloid and Lymphazurin blue, can be performed safely in pediatric skin and soft tissue malignancies. Further study with long-term follow-up will determine the utility and accuracy of this technique in pediatric malignancies. Copyright (C) 2000 by W.B. Saunders Company.

Original languageEnglish
Pages (from-to)961-964
Number of pages4
JournalJournal of Pediatric Surgery
Volume35
Issue number6
StatePublished - Jun 1 2000
Externally publishedYes

Fingerprint

Pediatrics
Biopsy
Lymph Node Excision
Alveolar Soft Part Sarcoma
Technetium Tc 99m Sulfur Colloid
Rhabdomyosarcoma
Neoplasms
Melanoma
cyhalothrin
Neoplasm Metastasis
Lymphoscintigraphy
Neoplasm Micrometastasis
Neurilemmoma
Operating Rooms
Radioisotopes
Dissection
Extremities
Lymph Nodes
Breast Neoplasms
Morbidity

Keywords

  • Lymphatic mapping
  • Malignancy
  • Sentinel node

ASJC Scopus subject areas

  • Surgery

Cite this

Neville, H., Andrassy, R. J., Lally, K. P., Corpron, C., & Ross, M. I. (2000). Lymphatic mapping with sentinel node biopsy in pediatric patients. Journal of Pediatric Surgery, 35(6), 961-964.

Lymphatic mapping with sentinel node biopsy in pediatric patients. / Neville, Holly; Andrassy, Richard J.; Lally, Kevin P.; Corpron, Cyndy; Ross, Merrick I.

In: Journal of Pediatric Surgery, Vol. 35, No. 6, 01.06.2000, p. 961-964.

Research output: Contribution to journalArticle

Neville, H, Andrassy, RJ, Lally, KP, Corpron, C & Ross, MI 2000, 'Lymphatic mapping with sentinel node biopsy in pediatric patients', Journal of Pediatric Surgery, vol. 35, no. 6, pp. 961-964.
Neville H, Andrassy RJ, Lally KP, Corpron C, Ross MI. Lymphatic mapping with sentinel node biopsy in pediatric patients. Journal of Pediatric Surgery. 2000 Jun 1;35(6):961-964.
Neville, Holly ; Andrassy, Richard J. ; Lally, Kevin P. ; Corpron, Cyndy ; Ross, Merrick I. / Lymphatic mapping with sentinel node biopsy in pediatric patients. In: Journal of Pediatric Surgery. 2000 ; Vol. 35, No. 6. pp. 961-964.
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