Potential Surgical and Oncologic Consequences Related to Skin Tattoos in the Treatment of Cervical Cancer

Köhler, Christian; Foiato, Tariane Friedrich; Marnitz, Simone; Schneider, Achim; Xin, Le; Doğan, Nasuh Utku; Pfiffer, Tatiana; Jacob, Anna; Mölgg, Andrea; Hagemann, Ingke; Favero, Giovanni

doi:10.1016/j.jmig.2016.07.016

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…Tattoo pigments have been identified to drain and deposit in extracellular spaces in lymph follicles, identified 4 years after tattooing (Tamura, Maeda, Terada, & Goto, 2019). Drainage of tattoo pigments have been associated with lymphadenopathy (Köhler et al, 2016) and may indicate a potential risk for nanoparticle radiosensitizers also.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of nanoparticle radiosensitization

Kempson

2020

WIREs Nanomed Nanobiotechnol

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Metal‐based nanoparticles applied to potentiating the effects of radiotherapy have drawn significant attention from the research community and are now available clinically. By improving our mechanistic understanding, nanoparticles are likely to evolve to provide very significant improvements in radiotherapy outcomes with only incremental increase in cost. This review critically assesses the inconsistent observations surrounding physical, physicochemical, chemical and biological mechanisms of radiosensitization. In doing so, a number of needs are identified for continuing research and are highlighted. The large degree of variability from one nanoparticle to another emphasizes that it is a mistake to generalize nanoparticle radiosensitizer mechanisms. Nanoparticle formulations should be considered in an analogous way as pharmacological agents and as a broad class of therapeutic agents, needing to be considered with a high degree of individuality with respect to their interactions and ultimate impact on radiobiological response. In the same way that no universal anti‐cancer drug exists, it is unlikely that a single nanoparticle formulation will lead to the best therapeutic outcomes for all cancers. The high degree of complexity and variability in mechanistic action provides notable opportunities for nanoparticle formulations to be optimized for specific indications. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Nanotechnology Approaches to Biology > Nanoscale Systems in Biology

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Section: Discussionmentioning

confidence: 99%

Mechanisms of nanoparticle radiosensitization

Kempson

2020

WIREs Nanomed Nanobiotechnol

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“…9 Histopathologically, brownish lymph nodes mimic the metastasis of malignant melanoma, 10 and swollen axillary lymph nodes mimic calcification on mammography examinations. 5 Köhler et al 4 observed tattoo lymphadenopathy in approximately 40% of patients with a tattoo on their limbs during cervical cancer surgery. Furthermore, 33% of the patients with tattoo lymphadenopathy had infectious lymphoid cysts postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…These reports indicate that tattoo lymphadenopathy imitates melanoma and metastasis of the primary tumor in tattooed patients with gynecologic malignancies. 2,4 In another report, mammography revealed that axillary lymphadenopathy induced by a tattoo imitated calcification. 5 The majority of these studies are case reports; the only prospective observational report of adverse events of tattoo lymphadenopathy, in cervical cancer patients with a lower limb tattoo, was by Köhler et al 4 No study has systematically evaluated the distribution of tattoo pigment.…”

Section: Introductionmentioning

confidence: 98%

Distribution of Tattoo Pigment in Lymph Nodes Dissected for Gynecological Malignancy

2019

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Tattoo pigment migrates to regional lymph nodes, often causing acute or chronic lymphadenopathy. Past reports on tattoo lymphadenopathy are almost exclusively from Western countries. However, systemic distribution of tattoo pigment in lymph nodes has not been assessed in detail. In this article, we report a Japanese case of cervical adenocarcinoma, in which we successfully assessed the distribution of tattoo pigment deposition in pelvic and para-aortic lymph nodes. A 61-year-old woman with Japanese-style tattoos on both arms and her left thigh visited another clinic with postcoital bleeding. She was diagnosed with clinical stage 1B1 (cervical adenocarcinoma) and underwent radical hysterectomy and pelvic/para-aortic lymph node dissection. Histopathological examination revealed deposition of a black pigment in multiple lymph nodes. The pigment was more abundant in the left pelvic lymph nodes than in the para-aortic lymph nodes, a finding suggestive of pigment drainage from the tattoo on the left thigh. She remains free of disease more than 1 year after surgery. The diagnosis of tattoo lymphadenopathy is not easy when clinical information is lacking. The differential diagnoses include metastatic melanoma. Clinicians and pathologists should better recognize this phenomenon.

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“…Many literature sources have reported on the above factors to evaluate the correlation with incidences of lymphocele [ 4 , 6 ]. Köhler et al reported that 33% patients developed infected lymphoceles on the side of the discolored lymph node due to tattoo [ 23 ]. In this study, there was no one with tattoos on the extremities.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Fibrin Sealant Patch in Reducing Drain Volume after Pelvic Lymph Node Dissection in Women with Gynecologic Malignancy

Kim

Choi

Kim

2017

BioMed Research International

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Background The goal of this study was to evaluate the effectiveness of fibrin sealant in decreasing postoperative lymphatic drainage in women after pelvic lymphadenectomy and/or para-aortic lymphadenectomy during gynecologic cancer surgery. Methods This study is a retrospective case-control study. Forty-five patients who underwent staging surgery were enrolled. Twenty-seven patients were in the fibrin sealant group (group A) and 18 in the control group (group B). The two groups were compared for the total volume of drain, hospital stay, harvested lymph node, and incidence of asymptomatic lymphocele. Lymphocele formation was evaluated by computed tomography (CT) on 3 months after surgery. Results There were no significant differences in patient demographics between group A and B with respect to age, BMI, and harvested lymph nodes. Patients who received fibrin sealants had reduced total volume of drainage from postoperative days 2 to 5 compared to the control group (group A versus group B: 994.819 ± 745.85 ml versus 1847.89 ± 1241.41 ml; P = 0.015). However no differences were observed in hospital stay (P = 0.282), duration of drain (P = 0.207), and incidence of asymptomatic lymphocele at 3 months (P = 0.126). Conclusion The results of this study indicate that the application of fibrin sealants after pelvic and/or para-aortic lymphadenectomy may reduce lymphatic drainage in gynecologic malignancy.

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Potential Surgical and Oncologic Consequences Related to Skin Tattoos in the Treatment of Cervical Cancer

Cited by 9 publications

References 21 publications

Mechanisms of nanoparticle radiosensitization

Mechanisms of nanoparticle radiosensitization

Distribution of Tattoo Pigment in Lymph Nodes Dissected for Gynecological Malignancy

Effectiveness of Fibrin Sealant Patch in Reducing Drain Volume after Pelvic Lymph Node Dissection in Women with Gynecologic Malignancy

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