Uccella Stefano, Bosco Mariachiara, Fagotti Anna, Garzon Simone, Zorzato Pier Carlo, Tinelli Raffaele, Biletta Elena, Porcari Irene, Liscia Daniele, Scambia Giovanni, Franchi Massimo
Department of Obstetrics and Gynaecology, AOUI Verona, University of Verona, Verona, Italy.
Division of Obstetrics and Gynaecology, Department of Maternal, Neonatal and Infant Health, ASL Biella, Italy.
Gynecol Oncol Rep. 2022 Jul 20;42:101047. doi: 10.1016/j.gore.2022.101047. eCollection 2022 Aug.
Sentinel lymph node (SLN) biopsy in apparent early-stage ovarian cancer may spare the surgical staging with extensive retroperitoneal dissection and its associated morbidity. However, SLN biopsy in ovarian cancer is still experimental and under investigation. A 46-year-old post-menopausal woman with bilateral apparent stage IC1 endometrioid ovarian cancer underwent surgical staging by SLN biopsy and subsequent comprehensive laparoscopic pelvic and -aortic lymphadenectomy. Out of 4 SLNs submitted to ultrastaging, one was positive for isolated tumour cells (ITCs). We submitted to ultra-staging all the other 24 pelvic and -aortic non-SLNs, which were reported negative for disease. This is the first reported case of comprehensive lymphadenectomy after SLN biopsy with universal ultrastaging of all non-SLNs in ovarian cancer. The presence of ITCs in only one SLN, with all other 27 lymph nodes negative at ultrastaging, is consistent with the SLN concept and the assumption of a reliable lymphatic pathway in ovarian cancer.
对于看似早期的卵巢癌，前哨淋巴结（SLN）活检可能避免进行广泛腹膜后淋巴结清扫的手术分期及其相关并发症。然而，卵巢癌的SLN活检仍处于试验和研究阶段。一名46岁绝经后妇女，双侧看似为IC1期子宫内膜样卵巢癌，通过SLN活检进行手术分期，随后进行了全面的腹腔镜盆腔和主动脉旁淋巴结清扫术。在送检超分期的4个SLN中，有1个发现存在孤立肿瘤细胞（ITC）呈阳性。我们对其他24个盆腔和主动脉旁非SLN进行了超分期，结果显示无疾病。这是首例报道的在卵巢癌SLN活检后对所有非SLN进行全面超分期的淋巴结清扫病例。仅1个SLN中存在ITC，而其他27个淋巴结超分期均为阴性，这与SLN概念以及卵巢癌中存在可靠淋巴引流途径的假设相符。
