SENTINEL NODE EXCISION FOR THE DIAGNOSIS OF METASTATIC NEUROENDOCRINECARCINOMA OF THE SKIN - A CASE-REPORT

The technology of sentinel node lymphoscintigraphy has made it possibl e to map and identify the lymph nodes draining the site of a primary c utaneous malignancy, This technique is now being used in the treatment of melanoma, and breast and vulvar carcinoma, With melanoma and breas t carcinoma, the histology of the sentinel lymph node (SLN) has been f ound to be reflective of the histology of the remainder of the nodal b asin, The concept of sampling the SLN is to provide an accurate stagin g for the entire nodal basin, obviating the need for a complete lympha denectomy if the SLN is negative, it is believed that cutaneous malign ancies with a propensity for regional metastasis, such as neuroendocri ne carcinoma of the skin, may spread via a similar lymphatic pathway i nvolving an SLN. Using this technique we identified and excised the SL Ns in a patient with a neuroendocrine carcinoma of the skin that conta ined the only focus of metastatic disease. Although this technique is still investigational we believe it holds great promise in being able to detect occult metastatic nodal disease in clinically node-negative patients.