Yasiru G Karunaratne1, Dakshika A Gunaratne2, Michael J Veness3,4,5. 1. Department of Surgery, St Vincent's Hospital, Sydney, Australia. 2. Department of Otolaryngology, Head and Neck Surgery, St George Hospital, Sydney, Australia. 3. Department of Radiation Oncology, Westmead Hospital, Sydney, Australia. 4. Crown Princess Mary Cancer Care Centre, Westmead Hospital, Sydney, Australia. 5. University of Sydney, Sydney, Australia.
Abstract
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine tumor arising on the head and neck in 40%-50% of patients. Between 20% and 40% will harbor subclinical nodal metastasis. METHODS: Using search terms 'Merkel AND sentinel', MEDLINE, PUMED, and EMBASE databases were systematically reviewed for publications regarding sentinel lymph node biopsy (SLNB) in classification I and II MCC of the head and neck. RESULTS: Twenty-nine publications encompassing 136 patients were included. The SLNB finding was positive in 42 patients (30.9%). Primary MCC was located on the malar/zygomatic (34.4%), forehead/frontal (13.5%), and nasal (13.5%) regions. Recurrence in an SLNB negative nodal basin result occurred in 10 patients (false negative rate of 19.2%). Site of primary MCC was not associated with a false-negative SLNB result; however, there was a non-statistically significant trend for increased frequency among midline lesions. CONCLUSIONS: Sentinel lymph node biopsy (SLNB) is recommended for eligible patients with classification I and II head and neck MCC.
BACKGROUND:Merkel cell carcinoma (MCC) is a rare and aggressive cutaneous neuroendocrine tumor arising on the head and neck in 40%-50% of patients. Between 20% and 40% will harbor subclinical nodal metastasis. METHODS: Using search terms 'Merkel AND sentinel', MEDLINE, PUMED, and EMBASE databases were systematically reviewed for publications regarding sentinel lymph node biopsy (SLNB) in classification I and II MCC of the head and neck. RESULTS: Twenty-nine publications encompassing 136 patients were included. The SLNB finding was positive in 42 patients (30.9%). Primary MCC was located on the malar/zygomatic (34.4%), forehead/frontal (13.5%), and nasal (13.5%) regions. Recurrence in an SLNB negative nodal basin result occurred in 10 patients (false negative rate of 19.2%). Site of primary MCC was not associated with a false-negative SLNB result; however, there was a non-statistically significant trend for increased frequency among midline lesions. CONCLUSIONS: Sentinel lymph node biopsy (SLNB) is recommended for eligible patients with classification I and II head and neck MCC.
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