GAMMA-PROBE-GUIDED LYMPH-NODE LOCALIZATION IN MALIGNANT-MELANOMA

The initial draining lymph node (sentinel node) has been successfully localized using intraoperative vital dye mapping and reportedly is pre dictive of regional nodal metastases in Clinical Stage 1 melanoma [1]. In an animal model, we previously established the technique of gamma- probe-guided localization of the technetium-99 sulfur colloid labelled sentinel node [2] and found its sensitivity equal to vital dye mappin g. We now report our initial experience using gamma-probe-guided local ization to identify and then surgically remove the first draining lymp h node(s) in 10 malignant melanoma patients. Lymphoscintigraphy was us ed to confirm localization. We conclude that this technique: (a) relia bly localizes the sentinel node draining the site of a primary melanom a, (b) allows the lymphatic bed to be checked intraoperatively verifyi ng complete sentinel node biopsy, and (c) is relatively simple and can be performed under local anaesthesia.