Interesting ImageLymphoscintigraphy of a Breast Tumor Showing Focal Tracer Accumulation Along the Falciform Ligament of the LiverVermeeren, L., MD*; Tanis, P. J., MD, PhD†; Nieweg, O. E., MD, PhD†; Olmos, R. A. Valdés, MD, PhD*Author Information From the Departments of *Nuclear Medicine, and †Surgery, The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Received for publication August 27, 2009; revision accepted October 17, 2009. Reprints: L. Vermeeren, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. E-mail: email@example.com. Clinical Nuclear Medicine: March 2010 - Volume 35 - Issue 3 - p 168-169 doi: 10.1097/RLU.0b013e3181cc642c Buy Metrics Abstract Technetium-99m nanocolloid was injected intratumorally in a patient with a left breast carcinoma. Sequential planar images showed drainage to an axillary and a left parasternal sentinel node. The liver showed faint homogeneous tracer uptake but there was also focal tracer accumulation adjacent to the liver. Single photon emission computed tomography–computed tomography (SPECT/CT) visualized the 2 sentinel nodes, but also intense tracer accumulation along the falciform ligament. Lymph from the breast can follow unpredictable pathways and may travel retrograde via the internal mammary chain towards lymphatic channels along the falciform ligament. This phenomenon might also explain incidental observations of umbilical metastasis in breast cancer. Copyright © 2010 Wolters Kluwer Health, Inc. All rights reserved.