Scintigraphic imaging of a nuchal sentinel node.

The cutaneous lymphatic drainage of the trunk is complex and its prediction is used to rely on the classic anatomic concepts of Sappey. Lymphoscintigraphy has shown significant discrepancy between the real sentinel nodal basins and the expected sites of drainage based solely on the old lymphatic anatomy. The author presents a case of upper back melanoma with unusual nuchal sentinel node demonstrated by technetium-99m filtered sulfur colloid scintigraphy.