Lymphoscintigraphy in the Diagnosis of а Sentinel Lymph Node in Patient with Malignant Oral Mucosa Before Biopsy. Clinical Observation

Objective. Regarding the role of lymphoscintigraphy in the diagnosis of sentinel lymph node in a patient with malignant lesions, an oral cavity examination is performed as a result of clinical observation.

Materials and Methods. The examination results and sentinel lymph node biopsy results are presented in a patient with T1N0M0 squamous cell carcinoma of the oral cavity, identified during intraoperative detection based on the results of indirect lymphoscintigraphy, supplemented by single-photon emission computed tomography with computed tomography (SPECT/CT).

Results. On the day of the surgical intervention, a lymphoscintigraphy was performed, during which the injection sites of the RFP were visualized, as well as the foci of hyperfixation located in the area of regional metastasis. These foci were located in the projection of the upper and middle jugular groups of the lymph nodes of the neck. During the surgical intervention, using a gamma detector, lymph nodes with an unchanged structure, but actively accumulating RFP, were identified. According to the results of the biopsy, malignant lesions of these lymph nodes were identified, which influenced the determination of the volume of lymphodissection.

Conclusion. Determining the exact location of a sentinel lymph node with a visually unchanged structure is an important step in staging malignant diseases, which will affect the patient's management.

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