Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques

Alberto JA Wainstein,1,2 Ana P Drummond-Lage,1 Milhem JM Kansaon,2 Gustavo O Bretas,2 Rodrigo F Almeida,3 Ana LF Gloria,3 Ana RP Figueiredo3 1Faculty of Medical Sciences of Minas Gerais, 2Oncad Surgical Oncology, 3Ophthalmology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil...

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Autores principales:	Wainstein AJA, Drummond-Lage AP, Kansaon MJM, Bretas GO, Almeida RF, Gloria ALF, Figueiredo ARP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2014
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/9dc0ecb5202446e598cc3b11e1286e21
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spelling	oai:doaj.org-article:9dc0ecb5202446e598cc3b11e1286e212021-12-02T01:51:38ZSentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques1177-5483https://doaj.org/article/9dc0ecb5202446e598cc3b11e1286e212014-12-01T00:00:00Zhttp://www.dovepress.com/sentinel-lymph-node-biopsy-for-conjunctival-malignant-melanoma-surgica-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483 Alberto JA Wainstein,1,2 Ana P Drummond-Lage,1 Milhem JM Kansaon,2 Gustavo O Bretas,2 Rodrigo F Almeida,3 Ana LF Gloria,3 Ana RP Figueiredo3 1Faculty of Medical Sciences of Minas Gerais, 2Oncad Surgical Oncology, 3Ophthalmology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil Background: The purpose of this report is to examine the viability and safety of preoperative lymphoscintigraphy and radio guided sentinel lymph node (SLN) biopsy for conjunctival melanoma, and to identify the best technique to perform this procedure.Methods: Three patients diagnosed with malignant melanoma of the conjunctiva underwent lymphoscintigraphy and SLN biopsy using a dual technique comprising isosulfan blue dye and technetium Tc 99m sulfur colloid. Each patient was anesthetized and the conjunctival melanoma was excised. SLNs were localized by a gamma probe, identified according to radioactivity and sentinel blue printing, and dissected, along with drainage of the associated lymphatic basins. The SLNs were evaluated by a pathologist using hematoxylin-eosin staining following serial sectioning and immunohistochemistry using a triple melanoma cocktail (S-100, Melan-A, and HMB-45 antigens).Results: Two SLNs were stained in the jugular chain during preoperative lymphoscintigraphy in the first patient, two SLNs were identified in the preauricular and submandibular areas in the second patient, and two SLNs were identified in the submandibular and parotid areas in the third patient. All lymph nodes identified by lymphoscintigraphy were dissected and identified at surgery with 100% accuracy in all three patients. All SLNs were histologically and immunohistochemically negative. Patients had good cosmetic and functional results, and maintained their visual acuity and ocular motility.Conclusion: Patients with conjunctival melanoma can undergo preoperative lymphoscintigraphy and SLN biopsy safely using radioactive technetium and isosulfan blue dye. Keywords: ocular melanoma, sentinel lymph node biopsy, lymphoscintigraphy, conjunctival melanomaWainstein AJADrummond-Lage APKansaon MJMBretas GOAlmeida RFGloria ALFFigueiredo ARPDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2015, Iss default, Pp 1-6 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Wainstein AJA Drummond-Lage AP Kansaon MJM Bretas GO Almeida RF Gloria ALF Figueiredo ARP Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
description	Alberto JA Wainstein,1,2 Ana P Drummond-Lage,1 Milhem JM Kansaon,2 Gustavo O Bretas,2 Rodrigo F Almeida,3 Ana LF Gloria,3 Ana RP Figueiredo3 1Faculty of Medical Sciences of Minas Gerais, 2Oncad Surgical Oncology, 3Ophthalmology Department, Federal University of Minas Gerais, Belo Horizonte, Brazil Background: The purpose of this report is to examine the viability and safety of preoperative lymphoscintigraphy and radio guided sentinel lymph node (SLN) biopsy for conjunctival melanoma, and to identify the best technique to perform this procedure.Methods: Three patients diagnosed with malignant melanoma of the conjunctiva underwent lymphoscintigraphy and SLN biopsy using a dual technique comprising isosulfan blue dye and technetium Tc 99m sulfur colloid. Each patient was anesthetized and the conjunctival melanoma was excised. SLNs were localized by a gamma probe, identified according to radioactivity and sentinel blue printing, and dissected, along with drainage of the associated lymphatic basins. The SLNs were evaluated by a pathologist using hematoxylin-eosin staining following serial sectioning and immunohistochemistry using a triple melanoma cocktail (S-100, Melan-A, and HMB-45 antigens).Results: Two SLNs were stained in the jugular chain during preoperative lymphoscintigraphy in the first patient, two SLNs were identified in the preauricular and submandibular areas in the second patient, and two SLNs were identified in the submandibular and parotid areas in the third patient. All lymph nodes identified by lymphoscintigraphy were dissected and identified at surgery with 100% accuracy in all three patients. All SLNs were histologically and immunohistochemically negative. Patients had good cosmetic and functional results, and maintained their visual acuity and ocular motility.Conclusion: Patients with conjunctival melanoma can undergo preoperative lymphoscintigraphy and SLN biopsy safely using radioactive technetium and isosulfan blue dye. Keywords: ocular melanoma, sentinel lymph node biopsy, lymphoscintigraphy, conjunctival melanoma
format	article
author	Wainstein AJA Drummond-Lage AP Kansaon MJM Bretas GO Almeida RF Gloria ALF Figueiredo ARP
author_facet	Wainstein AJA Drummond-Lage AP Kansaon MJM Bretas GO Almeida RF Gloria ALF Figueiredo ARP
author_sort	Wainstein AJA
title	Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
title_short	Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
title_full	Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
title_fullStr	Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
title_full_unstemmed	Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
title_sort	sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques
publisher	Dove Medical Press
publishDate	2014
url	https://doaj.org/article/9dc0ecb5202446e598cc3b11e1286e21
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_version_	1718402857617588224

Sentinel lymph node biopsy for conjunctival malignant melanoma: surgical techniques

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