Sentinel Lymph Node Biopsy in Head and Neck Cutaneous Malignant Melanoma

  • Ana Marta António Interna do Internato de Formação Específica em Dermatovenereologia, Serviço de Dermatovenereologia, Hospital Garcia de Orta, Almada, Portugal
  • Cecília Moura Assistente Hospitalar Graduada Sénior de Dermatovenereologia, Serviço de Dermatologia, Instituto Português de Oncologia de Lisboa Francisco Gentil, (IPOLFG), Lisboa, Portugal
  • Carina Semedo Assistente Hospitalar de Cirurgia Maxilo-Facial, Serviço de Cirurgia de Cabeça e Pescoço, IPOLFG, Lisboa, Portugal
  • Sandra Bitoque Assistente Hospitalar de Cirurgia Maxilo-Facial, Serviço de Cirurgia de Cabeça e Pescoço, IPOLFG, Lisboa, Portugal
  • Mariluz Martins Assistente Hospitalar Graduada de Estomatologia, Serviço de Cirurgia de Cabeça e Pescoço, IPOLFG, Lisboa, Portugal
  • Miguel Vilares Assistente Hospitalar Graduado de Cirurgia Maxilo-Facial, Serviço de Cirurgia de Cabeça e Pescoço, IPOLFG, Lisboa, Portugal
  • Manuela Pecegueiro Assistente Hospitalar Graduada e Diretora de Serviço de Dermatovenereologia, Serviço de Dermatologia, IPOLFG, Lisboa, Portugal
  • Jorge Rosa Santos Assistente Hospitalar Graduado Sénior e Diretor de Serviço de Cirurgia Maxilo-Facial, Serviço de Cirurgia de Cabeça e Pescoço, IPOLFG, Lisboa, Portugal
Keywords: Head and Neck Neoplasms, Melanoma, Sentinel Lymph Node Biopsy, Skin Neoplasms


Introduction: Sentinel lymph node biopsy (SLNB) is the standard of care for cutaneous melanoma, including head and neck melanoma. The aim of this study was to analyze and characterize SLNB in a population of head and neck melanoma patients.

Methods: A unicentric, retrospective study on patients with cutaneous head and neck melanoma who underwent SLNB in the Department of Head and Neck Surgery at the Portuguese Institute of Oncology (IPO) Lisbon between January 2010 and December 2017 was performed. The location of primary melanoma, the identification of SLN, the number of the excised SLN, its lymphatic basin origin and the presence of infraclinic metastasis were analysed.

Results:  Ninety-eight patients were eligible to undergo SLNB during the observation period. The most frequent locations of primary melanoma were the scalp (24.5%) and the auricular and periauricular region (23.5%) and the most frequent variants were the superficial spreading melanoma (40.8%) and nodular melanoma (30.6%). SLNB was successfully executed in 78 patients (79.6%). A mean of 3.8 lymph-nodes per patient were excised and in 16.7% SLN were excised in more than one lymphatic basin. The SLN were identified in parotid region (39.8%), level II (29.5%) and level V (18.2%). SLN metastases were detected in 13 patients (16.7%).

Conclusion: Surgical approach of head and neck cutaneous melanoma is particularly complex. The redundancy of lymphatic system, the multiple SLN and SLN basins influence the SLNB success and may contribute to high rates of false-negatives with its prognostic implications. All patients should be carefully monitored.  


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How to Cite
António, A. M., Moura, C., Semedo, C., Bitoque, S., Martins, M., Vilares, M., Pecegueiro, M., & Rosa Santos, J. (2019). Sentinel Lymph Node Biopsy in Head and Neck Cutaneous Malignant Melanoma. Journal of the Portuguese Society of Dermatology and Venereology, 77(2), 129-133.
Original Articles