Scintigraphic evaluation of lymphatic draining pathways in patients treated with pectoralis major (PM) and deltopectoralis (DP) myocutaneous flaps for oropharyngeal cancer

Conference · Sun Jan 01 00:00:00 EST 1984 · J. Nucl. Med.; (United States)

OSTI ID:6781123

Fernandez-Ulloa, M; Silver, F M; Vasavada, P J

Oropharyngeal tumors are routinely treated with extensive surgical resection and radiotherapy followed by PM and DP myocutaneous flaps performed for reconstruction purposes. The lymph vessels are the main pathways of oropharyngeal tumor dissemination and play an important role in the development of local recurrences and regional tumor invasion. To evaluate the local and regional residual pathways of lymphatic drainage after flap reconstruction, 25 pts (pts) were imaged 2-3 hours post-administration of .5 mCi of Tc-99m antimony colloid in the flaps. All pts had extensive tumor resection and PM (21 pts) or DP (4 pts) flaps. Fifteen pts had neck radiotherapy prior to the scintigrams. Following are the scintigraphic findings: 1) eight pts showed no visualization of lymph nodes although 4 of these had radiocolloid accumulation within the liver; 2) contralateral or ipsilateral cervical lymph nodes were seen in 16 pts; 3) xyphoid or internal mammary nodes were seen in 4 pts; 4) axillary nodes were seen in 5 pts; 5) liver visualization was present in 12 pts. Findings indicate that pathways of lymph drainage re-establish following head and neck surgery and flap reconstruction in most pts. These pathways are variable and unpredictable and lymphoscintigraphy may therefore play a major role to predict sites of future metastases and in planning therapy.

• Research Organization: E.L. Saenger Radioisotope Lab., Dept. of Radiology, Dept. Otolaryngology and Maxillofacial Surgery, Univ. of Cincinnati Medical Center, Cincinnati, OH
• OSTI ID: 6781123
• Report Number(s): CONF-840619-; TRN: 87-008842
• Journal Information: J. Nucl. Med.; (United States), Vol. 25:5; Conference: 31. annual meeting of the Society of Nuclear Medicine, Los Angeles, CA, USA, 5 Jun 1984
• Country of Publication: United States
• Language: English

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