The importance of sentinel node biopsy and examination in malignant melanoma of the head and neck.

Abstract

Background: Malignant melanoma of the head and neck is a highly aggressive tumor with a significant risk of regional and distant metastases. Due to the complex anatomy and rich lymphatic drainage of this area, accurate and timely diagnosis and staging are essential for optimal treatment planning. The sentinel lymph node plays a key role in assessing tumor spread and staging.

Materials and methods: A retrospective study was conducted on 26 patients with head and neck melanoma who underwent sentinel lymph node biopsy at our institution between 2017 and 2023. We evaluated the success rate of sentinel node localization, presence of metastases, and subsequent lymphadenectomy.

Results: Sentinel lymph nodes were successfully identified in 23 patients; 5 had positive findings (3 macrometastases, 1 micrometastasis, 1 isolated tumor cells). Lymphadenectomy was indicated in patients with macrometastases, while follow up monitoring was preferred for micrometastases and isolated tumor cells. One patient experienced a complication after lymphadenectomy. Most patients with negative sentinel nodes remained disease-free during follow-up.

Conclusion: Sentinel lymph node biopsy is a crucial tool for staging and treatment decision-making in head and neck malignant melanoma. The procedure's success depends on surgical expertise. Lymphadenectomy is indicated in cases of macrometastases, whereas micrometastases and isolated tumor cells warrant regular follow up. An individualized, multidisciplinary approach is essential.