Technetium-99m Sulfur-Colloid Cutaneous Lymphoscintigraphy in the Management of Truncal Melanoma

The authors developed a method of lymphoscintigraphy using 99mTc-SC that documents the directions of lymphatic drainage from a primary site of truncal melanoma. In 8 patients who had an excisional biopsy of the melanoma, migration from the injection site to regional lymph nodes was demonstrated. Four patients had lymphatic drainage correlating to that predicted by published anatomical pathways and 3 did not; in 1, more than one node-bearing area was at risk, but only one area had uptake, indicating unifocal drainage. This technique does not indicate metastatic disease per se, but indicates the anatomical direction of drainage, and is thus important in the surgical management of the patient.