Bowel visualization on the lymphoscintigraphy images of a bladder cancer patient due to inadvertent injection of the tracer in the rectal wall

Document Type : Case report

Authors

1 Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

The effectiveness of the sentinel lymph node mapping in patients with Urothelial carcinoma of the bladder is under investigation. Single photon emission computed tomography (SPECT/CT) and intraoperative sentinel node biopsy using gamma probe are performed to detect the exact location of the sentinel lymph node to be dissected during the surgery. In this case report, a 73-year old man with high grad urothelial carcinoma was referred to our nuclear medicine department for SPECT/CT, four hours after injection of the radiotracer through cystoscopy . SPECT/CT could not reveal any sentinel node; however, one sentinel lymph node was detected and harvested in the right external iliac region during surgery. SPECT/CT revealed unusual accumulation of tracer in large bowel which was due to sever adhesion of rectum and bladder, and inadvertent injection of the radiotracer into the rectal wall . During the sentinel lymph node procedure, the tracer should be injected with extreme caution and lymphoscintigraphy post injection may help detection of any injection failures.

Keywords

References

1. Zarifmahmoudi L, Ghorbani H, Sadeghi R, Sadri K, Tavakkoli M, Keshvari M, et al. Sentinel lymph node biopsy in muscle-invasive bladder cancer: single-center experience. Ann Nucl Med 2020; 34(10): 718-4.
2. Javan H, Gholami H, Assadi M, Pakdel AF, Sadeghi R, Keshtgar M. The accuracy of sentinel node biopsy in breast cancer patients with the history of previous surgical biopsy of the primary lesion: systematic review and meta-analysis of the literature. Eur J Surg Oncol. 2012; 38(2):95-109.
3. Ansari M, Rad MA, Hassanzadeh M, Gholami H, Yousefi Z, Dabbagh VR, et al. Sentinel node biopsy in endometrial cancer: systematic review and meta- analysis of the literature. Eur J Gynaecol Oncol. 2013; 34(5):387-401.
4. Sadeghi R, Gholami H, Zakavi SR, Kakhki VR, Tabasi KT, Horenblas S. Accuracy of sentinel lymph node biopsy for inguinal lymph node staging of penile squamous cell carcinoma: systematic review and meta-analysis of the literature. J Urol. 2012; 187(1):25-31.
5. Sadeghi R, Tabasi K, Bazaz SM, Kakhki VD, Massoom A, Gholami H, et al. Sentinel node mapping in the prostate cancer. Nuklear-medizin. 2011; 50(03):107-15.
6. Sherif A, De La Torre M, Malmstrom PU, Thorn M. Lymphatic mapping and detection of sentinel nodes in patients with bladder cancer. J Urol. 2001; 66(3):812-5.
7. Rosenblatt R, Johansson M, Alamdari F, Sidiki A, Holmström B, Hansson J, et al. Sentinel node detection in muscle-invasive urothelial bladder cancer is feasible after neoadjuvant chemotherapy in all pT stages, a prospective multicenter report. World J Urol 2016:1-7.
8. Aljabery F, Shabo I, Olsson H, Gimm O, Jahnson S. Radio‐guided sentinel lymph node detection and lymph node mapping in invasive urinary bladder cancer: a prospective clinical study. BJU inter-national. 2017; 120(3):329-36.
9. Sherif A, Garske U, de la Torre M, Thorn M. Hybrid SPECT-CT: an additional technique for sentinel node detection of patients with invasive bladder cancer. Eur Urol. 2006; 50(1):83-91.
10. Zarifmahmoudi L, Ghorbani H, Sadri K, Tavakkoli M, Keshvari M, Salehi M, et al. Sentinel Node Biopsy in Urothelial Carcinoma of the Bladder: Systematic Review and Meta-Analysis. Urol Int. 2019; 103(4):373-82.
11. Połom W, Markuszewski M, Cytawa W, Lass P, Matuszewski M. Radio-Guided Lymph Node Mapping in Bladder Cancer Using SPECT/CT and Intraoperative γ-Probe Methods. Clin Nucl Med. 2016; 41(8):362-7.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 9, Issue 2
July 2021
Pages 177-179

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