The sentinel lymph nodes revisited
Reviewed by Badr Eldin Mostafa

The concept of sentinel lymph node sampling has been around for some time. However, its acceptability in routine head and neck practice has yet to be established. This article presents the authors’ experience in 10 patients with Merkel cell carcinoma [eight T1N0Mo, one T2N0M and one T3N0M0], which is an aggressive cutaneous neuroendocrine tumour. Lymphoscinti-graphy was performed after infiltrating the tumour surround with Tc-99m labeled NANOCIS. Sampling of the sentinel node was performed during the excision of the primary tumour and stained by HPS and immunostains. Scintigraphy-positive nodes were detected in 7/10 patients. Three patients underwent neck dissection, either because of absent marker detection during scintigraphy or the absence of a surgically detected sentinel node. All these nodes were negative for malignancy. One patient had systemic metastases, but no lymph node recurrence 12 months later. The remaining nine patients were disease-free after two years’ follow-up. The conclusion of the authors is that sentinel node sampling in such patients is useful to determine the need for simultaneous neck dissection during excision or, instead, just follow-up. 

Prognostic value of sentinel lymph node in Merkel cell carcinoma of the head and neck.
Penicaud M, Cammilleri S, Giorgi R, et al.
EUROPEAN REVIEW OF ENT
2013;134(2):75-9.