Sentinel Lymph Node Mapping (LNM) in Endometrial Cancer (EC)
THE CASE
Juhi (name changed), 48 years of age, was constantly disturbed by her
irregular heavy vaginal bleeding. She consulted her gynaecologist at
Panipat who advised a routine USG followed by DAC. It was a real shock
for her and her family when the report indicated cancer of uterine lining.
She was advised an open surgery at Panipat with complete staging. Juhi
was completely shattered until someone suggested her to consult the
cancer team at BLK Hospital. The team counselled her to get it removed
Laparoscopically along with Sentinel Lymph Node Mapping (LNM ).
THE PROCEDURE
Sentinel Lymph Node (SLN) mapping in Endometrial Cancer provides a
bridge between overtreatment and understaging of patients. It targets
those nodes which are most likely to harbour the disease, and are easily
visible and hence amenable to removal easily.
At BLK, Radioactive tracer (Tc 99m colloid) and coloured dye
(methylene blue) are used to locate “hot” nodes. We utilized a combined
superficial and deep cervical injection of the tracer and dye for SLN
mapping on the day of surgery. Single-photon emission computed
tomography (SPECT) and gamma probe were used to locate the hot
nodes along with direct visualisation of blue nodes intraoperatively. The
surgery became easier and less traumatic as overzealous removal of
nodes was avoided and a minimally invasive approach could be utilised.
THE RESULT
The patient is doing well, post operatively and is on regular follow-up.
She did not experience any trauma of post-op morbidity and swollen
legs, thanks to the utmost care delivered by the team at BLK