Sentinel node biopsy in non-melanoma skin malignancies

At the Department of Dermatology, Okayama University Graduate School of Medicine and Dentistry, 14 patients with non-melanoma skin malignancies underwent lymphatic mapping and sentinel node biopsy from July 2000 to March 2004. Primary diagnoses were 9 squamous cell carcinomas (SCCs), 2 Merkel cell carcinomas (MCCs), 1 extramammary Paget carcinoma, 1 accessory breast cancer and 1 leiomyosarcoma. Sentinel node biopsies were performed using preoperative lymphoscintigraphy and blue dye from July 2000 to October 2001 and using those strategies in addition to intraoperative radiolocalization from November 2001. We identified sentinel lymph nodes in all 14 patients. Four patients (3 SCCs, 1 extramammary Paget carcinoma) had tumor-positive sentinel lymph nodes. In these 4 patients, radical lymph node dissection was performed, revealing further metastases in 2 patients (1 SCC, 1 extramammary Paget carcinoma). One of the 2 patients (extramammary Paget carcinoma) died of metastatic disease. No patient with a negative sentinel lymph node had tumor dissemination at a median follow-up of 22.6 months. Sentinel node biopsy is a minimally invasive and highly sensitive staging tool for non-melanoma skin malignancies.