Importance of the sentinel lymph node mapping by lymphoscintigraphy in melanoma and Merkel cell cancer

Learning Objectives 1. To illustrate sentinel lymph node drainage variability in cutaneous malignancies. 2. Importance of identifying sentinel lymph nodes by lymphoscintigraphy to obtain successful sentinel lymph node biopsy.

Clinical prediction of lymphatic drainage in the head neck is unreliable. Lymphatic drainage sites in patients are discordant with clinical prediction. A successful localization of lymph nodes for biopsy in melanoma and merkel cell cancers requires an accurate map of head and neck lymphatic drainage. Radioguided sentinel lymph node biopsy is important to accurately stage the disease. It is safe, efficient and a cost effective modality to identify the sentinel lymph node in patients with cutaneous malignancies (melanoma, merkel cell and vulvar cancers)