RADIOLOCALIZATION OF THE SENTINEL LYMPH-NODE IN MERKEL CELL-CARCINOMA- A CLINICAL ANALYSIS OF 7 CASES

Merkel cell carcinoma (MCC) is a rare cutaneous skin lesion with a var iable but often aggressive clinical course. Patient survival correlate s with nodal status and the presence of distant metastases. The histol ogic status of the sentinel lymph node consistently correlates with th e incidence of regional lymphatic metastases in other dermal malignanc ies. The technique of radiolocalization and surgical resection of the sentinel lymph node using an intraoperative gamma probe is used to gui de clinical management in these patients. We report on seven cases of MCC managed utilizing this technique. Four patients had negative senti nel nodes and no other nodal disease at completion lymphadenectomy (n = 2) or clinical follow-up (n = 2) and currently remain disease free. Two patients had a positive sentinel node but no other positive lymph nodes at completion lymphadenectomy; one of them developed regional re currence. One patient with a positive sentinel node and six additional positive nodes developed extensive nodal disease and systemic recurre nce during radiotherapy and expired of MCC. Our results suggest that t he sentinel node was identified and removed successfully using radiolo calization making this technique useful in the staging and therapy of patients with MCC. (C) 1998 Wiley-Liss, Inc.