Sentinel lymph node navigation surgery in Paget's disease of the vulva

A 78-year-old woman with vulvar Paget's disease was examined with lymphoscintigraphy. Neither regional nor distant metastases nor inguinal or femoral lymph node metastases were evident clinically. Sentinel lymph nodes were identified before and during operation in both groin areas. The patient underwent selective sentinel lymph node sampling with a hand-held gamma probe and local vulvectomy. Histopathologic examination of the specimen revealed intraepithelial Paget's disease, and there was no evidence of cancer (stage T2N0M0). Postoperative lymphedema did not occur. The sentinel lymph node procedure for vulvar Paget's disease may be a promising technique for minimally invasive surgery.