LYMPHOSCINTIGRAPHY AND SPECT/CT ADVANTAGES IN VERIFYING LYMPHORRHEA: A CLINICAL CASE EXHAMPLE OF EXTRA-ABDOMINAL DESMOID FIBROMA TREATMENT
Abstract
Objective. To demonstrate the effectiveness of lymphoscintigraphy and SPECT/CT in identification of the lymphorrhea in posttreatment of extra-abdominal desmoid fibroma period.
Materials and methods. 38-year-old patient complained on the flaccid granulating wound of the anterior surface of the right thigh. There was a history of surgical treatment of extra-abdominal
desmoid fibroma located at the inner surface of the middle third of right thigh. Postoperative course of radiation therapy; neurolysis of the sciatic and femoral nerves. Eventually, she suffered
from active liquid discharge in the wound area with the bandage getting wet at the posttreatment period. The static lymphoscintigraphy and regional SPECT/CT of the lower extremities and pelvis
were performed after subcutaneous injection of 99mTc-sulfur colloid. Results. Lymphoscintigraphy showed a failure of the lymphatic vessels drainage function at the right lower limb. Moreover, shunt formation between the superficial and deep lymphatic tracts was revealed. Based on the results of the hybrid imaging study the lymphorrhea in the region of the middle third of the right thigh was confirmed. Conclusion. SPECT/CT with 99mTc-sulfur colloid is a highly informative method for verifying lymphorrhea, improves the diagnostic accuracy of indirect lymphoscintigraphy, and makes it possible to differentiate the superficial and deep lymphatic tracts.
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