A 58-year-old man underwent a punch biopsy of a suspicious lesion below the inferior angle of the left scapula. The pathology was malignant melanoma with a Breslow depth of 1.06 mm. Because the lesion was in the intermediate depth range (1-4 mm) the patient was scheduled for sentinel lymph node biopsy for staging purposes.
The patient underwent technetium (99mTc sulfur colloid) scan the afternoon prior to surgery. The scan (posterior view) showed a hot spot only in the left axilla. Note the square shield over the site where the 3 millicuries of Tc was injected to allow visualization of the nearby sentinel node.
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