Tattoo of more than lymph nodes

摘要

To the Editor: We read with interest the article by Bartels et al1 describing a higher lymph node yield at surgery associated with preoperative colonoscopic tattooing for colorectal cancer. It is possible that tattooing may also help with the identification of peritoneal disease. We previously described a case wherein carbon pigment was seen in peritoneal adenocarcinoma deposits after preoperative tattooing of a rectal cancer. After neoadjuvant chemotherapy, the visually striking black deposits were seen at surgery on the rectosigmoid mesentery and adjacent to the cecal pole, without other areas of carbon staining in the peritoneum identified. The carbon pigment was confirmed at histopa-thology within the carcinomatous deposits, both free and within macrophages. The mechanism by which this occurred is unclear; of note, a saline solution preinjection technique was not used in our case.