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|Title:||Interrogating the Impassable: A Case Series and Literature Review of Unilateral SPECT-CT Groin Visualization in Men With Penile Cancer.||Austin Authors:||O'Brien, Jonathan S;Teh, Jiasian ;Kelly, Brian D ;Chen, Kenneth;Manning, Todd G ;Furrer, Marc;Chee, Justin ;Lawrentschuk, Nathan||Affiliation:||EJ Whitten Prostate Cancer Research Center at Epworth Healthcare, Melbourne, VIC, Australia
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
Department of Urology, Singapore General Hospital, Singapore, Singapore..
Young Urology Researchers Organization (YURO), Melbourne, VIC, Australia
Department of Urology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
MURAC Health, East Melbourne, VIC, Australia
Division of Cancer Surgery, Peter MacCallum Cancer Center, Melbourne, VIC, Australia
|Issue Date:||2022||Date:||2022||Publication information:||Frontiers in Surgery 2022; 9: 882011||Abstract:||Penile squamous cell carcinoma (SCC) is a rare malignancy, which is known to invade local inguinal lymph nodes prior to progressing to the pelvis. Dynamic sentinel lymph node biopsy (DSLNB) is a standard for the minimally invasive assessment of lymphadenopathy in patients with subclinical groin metastasis. Hybrid 99mTc Single-Photon Emission Computed Tomography (SPECT-CT) has been shown to increase the accuracy of identifying first draining "sentinel" nodes (SN). Unilateral inguinal visualization on SPECT-CT is a rare presentation, which may increase the likelihood of a false negative SN biopsy. Retrospective analysis from three-penile cancer uro-oncologists in Melbourne, Australia identified 78 groins undergoing DSLNB for intermediate/high risk primary disease. Unilateral SPECT-CT results were observed in four patients suggesting a functional pattern of lymph diversion. Analysis confirmed malignancy (n = 2), sarcoidosis (n = 1), and evidence of local inflammation in SPECT-CT negative groins. Findings re-iterate the role of SPECT-CT a pre-operative adjunct. Experienced multimodal groin assessment using palpation, SPECT-CT, lymphoscintigraphy, and blue dye tracking remains paramount. Unilateral SN on pre-operative SPECT-CT in men with intermediate/high-risk penile SCC should elicit a higher degree of clinical suspicion. We recommend a low threshold for recommending radical inguinal lymph node dissection (ILND) for groins refractory to minimally invasive assessment.||URI:||https://ahro.austin.org.au/austinjspui/handle/1/30328||DOI:||10.3389/fsurg.2022.882011||Journal:||Frontiers in Surgery||PubMed URL:||35662824||ISSN:||2296-875X||Type:||Journal Article||Subjects:||SPECT-CT
dynamic sentinel lymph node biopsy (DSLNB)
minimally invasive surgeries (MIS)
sentinel node (SN)
|Appears in Collections:||Journal articles|
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