This case report aims to describe the use of CT guided wire localization for excision of a non-palpable PET avid lymph node (LN) in the groin. We present a case of a patient with a recurrent very distal rectal adenocarcinoma metastasized to a right inguinal LN who underwent wire localization under CT scan guidance just prior to surgical excision and inguinal node dissection. We adjusted our incision to ensure not only the LN of interest was easily found and excised but also aesthetic closure based on its location. The node of interest proved to be recurrent metastatic rectal adenocarcinoma (proven preoperatively by a needle biopsy with clip placement to facilitate localization). We believe this technique to be useful for both localizing groin LN and allowing for optimal aesthetic closure.
