Sentinel node in melanoma patients: triple negativity with routine techniques and PCR as positive prognostic factor for survival.

Lymph node mapping and sentinel lymph node biopsy are currently used to stage patients with cutaneous malignant melanoma. Immunohistochemical stains contribute to the detection of micrometastases; however, molecular biology techniques are associated with better diagnostic sensitivity. Sixty sentinel lymph nodes were included in this study.

[Study of the sentinel lymph node. Diagnosis and treatment of cutaneous malignant melanoma stages I and II].

Survival at 5 years of patients with localized primary malignant melanoma is about 80%, compared with a 35% survival in case of lymph nodes involvement. Sentinel lymph node(s) from 45 subjects with diagnosis of malignant melanoma stage I or II was/were studied with hematoxylin-eosin (HE), immunohistochemistry (IHC) and molecular biology (MB) techniques. The population was divided into three groups: HE-/IHC+/MB+, where 67% patients died; HE-/IHC-/MB+, where 57% died; and HE-/IHC-/MB-, where 100% of the patients are alive, with no lymphadenectomy and a median follow-up of 60 months.

Sentinel lymph node: detection of micrometastases of melanoma in a molecular study.

Introduction: Lymph node status in patients with cutaneous malignant melanoma is the most important prognostic factor. Patients with clinically positive nodes (stage III) should undergo therapeutic lymphadenectomy; however, the surgical approach to the regional disease in patients with negative clinical examination (stage I and II) is still controversial. Selective lymphadenectomy consists of the intraoperative identification of the first node in the nodal basin, the sentinel lymph node (SLN).

Voice changes after thyroidectomy without recurrent laryngeal nerve injury.

Background: Injury of the inferior laryngeal nerve is not the only cause of voice alteration after thyroidectomy; many patients notice minimal changes immediately after operation, without evidence of inferior laryngeal nerve damage. We hypothesized that there may be other causes for voice modification, such as injuries of the superior laryngeal nerve, prethyroid strap muscles, and cricothyroid muscles. We describe voice changes after total thyroidectomy, without inferior laryngeal nerve injury, using a computer program to objectively compare different patterns of voice.

[Tc-99-sestamibi scan in the preoperative localization of abnormal hyperfunctioning parathyroid glands].

Hyperparathyroidism is a relatively frequent condition mostly due to a solitary parathyroid adenoma. Although it has been claimed that surgical exploration is the best way to visualize the abnormal parathyroid gland, several imaging techniques have been proposed to localize it in order to simplify and shorten the surgical procedure. Echography, thalium-technetium scintigraphy, computerized tomography and nuclear magnetic resonance have shown a mean sensitivity of 75% which can be increased to about 90% by combining 2 or more of these procedures.