A 52-year-old man underwent punch biopsy of a pigmented lesion of his right thigh. The diagnosis was malignant melanoma with a depth of 0.25mm. Although lymph node metastasis was highly unlikely (1-2%), the patient desired sentinel lymph node biopsy.
The patient was given intradermal peri-lesion injections of 1 millicurie of technetium sulfur colloid in a volume of 0.5cc the afternoon before surgery, followed by nuclear medicine scan shown above.
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The pattern of radionucleotide distribution is superimposed on a drawing of the region. radiating from the shielded lesion are three distinct lymphatic channels leading to three sentinel inguinal lymph nodes in a chain.
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