The sentinel node procedure with Patent Blue V dye in the surgical treatment of papillary thyroid carcinoma

How far to extend the surgical treatment of pagillary thyroid carcinoma (FT C) is still an open question. A contribution may come From intra-operative lymphatic mapping because. in other malignancies, the procedure has become an important aid in defining lymph node status. To assess the feasibility o f using the sentinel lymph node (SLN) technique with the intratumoral injec tion of Potent Blue V dye to guide nodal dissection in PTC, 29 patients wit h a preoperative diagnosis of PTC and no clinical or ultrasonographic evide nce of nodal involvement underwent cervicotomy and exposure of the thyroid Bland, followed by Patent Blur V dye injection into the thyroid nodule. Tot al thyroidectomy was subsequently performed, resecting the lymph nodes at l evels III, IV, VI and VII. The thyroid, SLN and the other lymph nodes wore snap-frozen and submitted for both intra-operative and subsequent definitiv e pathological evaluation. Intra-operative lymphatic mapping located the SL N in 22/29 patients (75.9%) and the SLN revealed neoplastic involvement in 4/22 (18.2%); other lymph nodes were also positive in 2 cases. In the 18 pa tients whose SLNs were not metastatic, the other nodes were also disease-fr ee. The SLN technique thus seems helpful in avoiding unnecessary lymph node dissection in PTC without spread to the SLN.