Fwd: Nonvisualization of a Sentinel Lymph Node on Lymphoscintigraphy Requiring Reinjection of Sulfur Colloid in a Patient With Breast Cancer.

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From: HubMed - breast cancer <rssfwd@rssfwd.com>
Date: Fri, May 23, 2008 at 7:59 PM
Subject: Nonvisualization of a Sentinel Lymph Node on Lymphoscintigraphy Requiring Reinjection of Sulfur Colloid in a Patient With Breast Cancer.
To: mesothelioma77@gmail.com


[1]Clin Nucl Med. 2008 Jun; 33(6): 389-390
Teal CB, Brem RF, Rapelyea JA, Akin EA

PURPOSE:: The injection techniques and use of lymphoscintigraphy for sentinel lymph node (SLN) biopsy in breast cancer patients vary. Some do not advocate routine use of lymphoscintigraphy. The purpose of this case report is to illustrate when lymphoscintigraphy should be used. METHODS:: At our institution, we use periareolar intradermal injections of 0.6 mCi Tc-99m sulfur colloid followed by lymphoscintigraphy with reported identification rates greater than 99%. The only patient in our series who did not have a SLN identified had presented after excisional biopsy of an upper outer quadrant cancer. We report the case of another patient who presented after excision of an upper outer quadrant invasive ductal carcinoma and had no evidence of lymphatic drainage on lymphoscintigraphy after the periareolar injections of radioisotope. RESULTS:: Additional injections of 0.4 mCi Tc-99m sulfur colloid were performed lateral to the incision in the upper outer quadrant. On lymphoscintigraphy a SLN was visualized and was subsequently successfully identified intraoperatively. CONCLUSION:: This case report supports the value of lymphoscintigraphy for successful identification of a SLN in a patient with prior surgery. We therefore recommend imaging patients who have had prior breast surgery, particularly excisions in the upper outer quadrant.



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Source: http://www.hubmed.org/display.cgi?uids=18496442
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Fwd: Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis.

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From: HubMed - cancer <rssfwd@rssfwd.com>
Date: Fri, May 23, 2008 at 7:59 PM
Subject: Simultaneous thigh muscle metastasis from lung cancer and Escherichia coli gas producing myonecrosis.
To: mesothelioma77@gmail.com


[1]Skeletal Radiol. 2008 May 22;
Martinez GE, Coursey CA, Dodd L, Martinez S

We present the case of a 41-year-old man with known large cell lung cancer who had undergone left pneumonectomy 7 months prior and who presented with a large intramuscular mass involving the posterior left thigh and upper calf. This thigh mass was ultimately surgically explored, and specimens yielded both Escherichia coli organisms and cells reflecting a skeletal muscle metastasis from the patient's known lung cancer. The patient was also found to have a rectal metastasis from his lung cancer. Intramuscular abscesses produced by gastrointestinal tract flora are a well-known presentation of colon cancer. To our knowledge, this is the first case report of the simultaneous occurrence of a skeletal muscle metastasis and an E. coli abscess in the same anatomic location. We believe the patient's rectal metastasis may have been the intermediate step in this process.



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Source: http://www.hubmed.org/display.cgi?uids=18496688
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