There are considerable variations between particle sizes and particle composition, time between injection and examination. The lack of standardization of technique is a major setback for challenging procedure to gain popularity across the globe. Another important of the studies is lack of uniformity reporting data.

Measures are needed to enhance radioisotope develop a swift and precise technique to localise the SLN. In the relative absence of hard facts and in the presence of debatable evidence this procedure cannot be recommended as standard of care at present. More additional, Inhibitors,research,lifescience,medical definitive, adequately powered studies with a virtuous selection criteria, predefined surgical technique Inhibitors,research,lifescience,medical and that takes into consideration the existing shortcomings of the procedure would be ideal to evaluate the role of SLN biopsy in oesophageal cancers. Conclusions SLN biopsy is feasible in oesophageal resections

with conservative lymphadenectomy and, when successful, initial results suggest it is very accurate Inhibitors,research,lifescience,medical in predicting overall nodal status. However, further work is needed to optimize radiocolloid type, refine the technique and develop a quick and accurate way to determine SLN status intraoperatively. SLN biopsy may become standard of care in oesophageal cancer in the near future, especially in the setting of minimally invasive surgery. Whether it will ever be useful as a tool for tailoring a lymphadenectomy is a question for the future. Acknowledgements Disclosure: The authors declare no conflict of interest.
A 56-year-old female diagnosed with UM with liver metastasis was placed on local TACE treatment. She received three TACE treatments Inhibitors,research,lifescience,medical with Carmustine, and one TACE with DEBDOX. An MRI done after these cycles showed persistence of extensive liver metastasis despite the above mentioned therapy (Figure

1). She was therefore treated with a second cycle of TACE-DEBDOX one month later. Eighteen hours after TACE-DEBDOX, the patient experienced expressive aphasia, Inhibitors,research,lifescience,medical bilateral blurry vision, dysarthria and dysmetria. Abdominal exam revealed mild Bcl-2 protein family hepatomegaly and upper abdominal tenderness without guarding or rigidity. Her blood pressure (BP) had been slowly trending up after the TACE with a peak of 180/113 (mean arterial pressure =135 mmHg) Thymidine kinase 12 hours after the procedure; this was treated with intravenous metoprolol. Laboratory investigations revealed an elevated AST (309 IU/L) and ALT (199 IU/L) with a normal total bilirubin of 0.3 mg/dL. Figure 1 MRI-abdomen with IV contrast shows extensive hepatomegaly with a large, confluent mass with necrotic regions most likely secondary to previous TACE treatments. TACE, transarterial chemoembolization. Brain MRI showed a hyper intense signal in the subcortical white matter of the bilateral occipital lobes, consistent with posterior reversible encephalopathy syndrome (PRES) (Figure 2).