Coronavirus disease 2019 vaccine mimics lymph node metastases in patients undergoing skin cancer follow-up: A monocentre study

The coronavirus disease 2019 (COVID-19) pandemic has changed the lives of people around the world. Fortunately, sufficient vaccines are now available. Local reactions with ipsilateral lymphadenopathy are among the most common side effects. We investigated the impact of lymphadenopathy after COVID-19...

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Bibliographic Details
Published in:European journal of cancer (1990) 2021-09, Vol.154, p.167-174
Main Authors: Placke, Jan-Malte, Reis, Henning, Hadaschik, Eva, Roesch, Alexander, Schadendorf, Dirk, Stoffels, Ingo, Klode, Joachim
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Cancer
Carcinoma, Merkel Cell - secondary
Computed tomography
Coronaviruses
COVID-19
COVID-19 - immunology
COVID-19 - prevention & control
COVID-19 - virology
COVID-19 vaccine
COVID-19 vaccines
COVID-19 Vaccines - administration & dosage
COVID-19 Vaccines - adverse effects
Diagnosis, Differential
Diagnostic Errors
Female
Germany
Humans
Immunization
Lymph nodes
Lymph Nodes - diagnostic imaging
Lymph Nodes - drug effects
Lymph Nodes - pathology
Lymphadenopathy
Lymphadenopathy - chemically induced
Lymphadenopathy - diagnostic imaging
Lymphatic Metastasis
Lymphatic system
Male
Malpractice
Melanoma
Melanoma - secondary
Merkel cell carcinoma
Metastases
Metastasis
Middle Aged
Original Research
Pandemics
Patients
Positron emission
Positron emission tomography
Predictive Value of Tests
Side effects
Skin cancer
Skin Neoplasms - pathology
Tomography
Treatment Outcome
Tumors
Ultrasonic imaging
Ultrasonography
Ultrasound
Vaccination - adverse effects
Vaccines
Viral diseases
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Description
Summary:The coronavirus disease 2019 (COVID-19) pandemic has changed the lives of people around the world. Fortunately, sufficient vaccines are now available. Local reactions with ipsilateral lymphadenopathy are among the most common side effects. We investigated the impact of lymphadenopathy after COVID-19 vaccination on the value of ultrasound in tumour patients. Patients with melanoma or Merkel cell carcinoma were included who underwent lymph node excision and received COVID-19 vaccination within 6 weeks before surgery. The consistency of the preoperative ultrasound findings with the histopathologic findings was investigated. Eight patients were included (two Merkel cell carcinoma and six melanoma patients) who underwent lymph node excision between 16th April 2021 and 19th May 2021 and had previously received COVID-19 vaccination. In three of the eight patients (one Merkel cell carcinoma and two melanoma patients), lymph node metastases were erroneously diagnosed preoperatively during tumour follow-up with physical examination, ultrasound, and or fluorodeoxyglucose (FDG)–positron emission tomography (PET)/computed tomography (CT). In these three patients, the suspected lymph node metastases were located in the left axilla after COVID-19 vaccination in the left upper arm, which resulted in selective lymph node removal in two patients and complete lymphadenectomy in one patient. COVID-19 vaccine–associated lymphadenopathy is expected to be observed much more frequently in the near future because of increasing vaccination rates. This cause of lymphadenopathy, which may in ultrasound as well as in FDG PET/CT resemble lymph node metastases, must be considered, especially in oncologic patients undergoing tumour follow-up. In addition, COVID-19 vaccination should be given as far away as possible from an underlying primary on the contralateral side to avoid oncologic misdiagnosis followed by malpractice. •Lymphadenopathy after coronavirus disease 2019 (COVID-19) vaccination mimics lymph node metastasis in ultrasound.•Lymphadenopathy after COVID-19 vaccination may lead to unnecessary lymph node extirpations.•Vaccination should be administered as far as possible from the site of the primary tumour.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.06.023