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Sentinel node biopsy in local anaesthesia in patients with head and neck Merkel cell carcinoma

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European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the applicability of sentinel lymph node (SLN) biopsy in patients with head and neck Merkel cell carcinoma (MCC). A prospective study for nine stage I MCC head and neck patients was conducted between 2001 and 2005. Patients underwent SLN biopsy in conjunction with radical tumour excision. Nine consecutive head and neck MCC patients were included, of whom five were women. All the patients were at stage I. In one patient, no SLNs could be localised on lymphoscintigraphy or perioperatively; eight patients underwent removal of one eight SLNs. None of the patients had any complications directly related to the SLNB. Those patients who demonstrated metastatic disease in the SLNs had waiting periods of 25 and 54 days, respectively. Only the free microvascular free flap reconstructions were done under general anaesthesia, the other reconstructions and the removal of the SLNs were done under local anaesthesia. Aggressive nature and the head and neck location of most MCCs is challenging for the surgeon. Patients are usually elderly with comorbities, which sets limits for anaesthesia. In our opinion, it is not mandatory to perform SLN biopsy under general anaesthesia.

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Abbreviations

MCC:

Merkel cell carcinoma

SLN:

sentinel lymph node

SLNB:

sentinel lymph node biopsy

STSG:

split thickness skin graft

ELNS:

elective lymph node dissection

References

  1. Allen PJ, Bowne WB, Jaques DP et al (2005) Merkel cell carcinoma: prognosis and treatment of patients from a single institution. J Clin Oncol 23:2300–2309

    Article  PubMed  Google Scholar 

  2. Koljonen V, Bohling T, Granhroth G et al (2003) Merkel cell carcinoma: a clinicopathological study of 34 patients. Eur J Surg Oncol 29:607–610

    Article  PubMed  CAS  Google Scholar 

  3. Tai PT, Yu E, Tonita J et al (2000) Merkel cell carcinoma of the skin. J Cutan Med Surg 4:186–195

    PubMed  Google Scholar 

  4. Brissett AE, Olsen KD, Kasperbauer JL et al (2002) Merkel cell carcinoma of the head and neck: a retrospective case series. Head Neck 24:982–988

    Article  PubMed  Google Scholar 

  5. Hitchcock CL, Bland KI, Laney RG 3rd et al (1988) Neuroendocrine (Merkel cell) carcinoma of the skin. Its natural history, diagnosis, and treatment. Ann Surg 207:201–207

    Article  PubMed  CAS  Google Scholar 

  6. Yiengpruksawan A, Coit DG, Thaler HT et al (1991) Merkel cell carcinoma. Prognosis and management. Arch Surg 126:1514–1519

    PubMed  CAS  Google Scholar 

  7. Mehrany K, Otley CC, Weenig RH et al (2002) A meta-analysis of the prognostic significance of sentinel lymph node status in Merkel cell carcinoma. Dermatol Surg 28:113–117

    Article  PubMed  Google Scholar 

  8. Ames SE, Krag DN, Brady MS (1998) Radiolocalization of the sentinel lymph node in Merkel cell carcinoma: a clinical analysis of seven cases. J Surg Oncol 67:251–254

    Article  PubMed  CAS  Google Scholar 

  9. Rodrigues LK, Leong SP, Kashani-Sabet M et al (2001) Early experience with sentinel lymph node mapping for Merkel cell carcinoma. J Am Acad Dermatol 45:303–308

    Article  PubMed  CAS  Google Scholar 

  10. Hodgson NC (2005) Merkel cell carcinoma: changing incidence trends. J Surg Oncol 89:1–4

    Article  PubMed  Google Scholar 

  11. Landis SH, Murray T, Bolden S et al (1998) Cancer statistics, 1998. CA Cancer J Clin 48:6–29

    Article  PubMed  CAS  Google Scholar 

  12. Colombo F, Holbach LM, Junemann AG et al (2000) Merkel cell carcinoma: clinicopathologic correlation, management, and follow-up in five patients. Ophthal Plast Reconstr Surg 16:453–458

    Article  PubMed  CAS  Google Scholar 

  13. Tsang G, O’Brien P, Robertson R et al (2004) All delays before radiotherapy risk progression of Merkel cell carcinoma. Australas Radiol 48:371–375

    Article  PubMed  CAS  Google Scholar 

  14. Anderson SE, Beer KT, Banic A et al (2005) MRI of Merkel cell carcinoma: histologic correlation and review of the literature. AJR Am J Roentgenol 185:1441–1448

    Article  PubMed  Google Scholar 

  15. Pergolizzi J Jr, Sardi A, Pelczar M et al (1997) Merkel cell carcinoma: an aggressive malignancy. Am Surg 63:450–454

    PubMed  Google Scholar 

  16. Savage P, Constenla D, Fisher C et al (1997) The natural history and management of Merkel cell carcinoma of the skin: a review of 22 patients treated at the Royal Marsden Hospital. Clin Oncol (R Coll Radiol) 9:164–167

    CAS  Google Scholar 

  17. Penn I, First MR (1999) Merkel’s cell carcinoma in organ recipients: report of 41 cases. Transplantation 68:1717–1721

    Article  PubMed  CAS  Google Scholar 

  18. Dancey AL, Rayatt SS, Soon C et al (2006) Merkel cell carcinoma: a report of 34 cases and literature review. J Plast Reconstr Aesthet Surg 59:1294–1299

    Article  PubMed  CAS  Google Scholar 

  19. Goepfert H, Remmler D, Silva E et al (1984) Merkel cell carcinoma (endocrine carcinoma of the skin) of the head and neck. Arch Otolaryngol 110:707–712

    PubMed  CAS  Google Scholar 

  20. Wasserberg N, Schachter J, Fenig E et al (2000) Applicability of the sentinel node technique to Merkel cell carcinoma. Dermatol Surg 26:138–141

    Article  PubMed  CAS  Google Scholar 

  21. Gollub MJ, Gruen DR, Dershaw DD (1996) Merkel cell carcinoma: CT findings in 12 patients. AJR Am J Roentgenol 167:617–620

    PubMed  CAS  Google Scholar 

  22. Hill AD, Brady MS, Coit DG (1999) Intraoperative lymphatic mapping and sentinel lymph node biopsy for Merkel cell carcinoma. Br J Surg 86:518–521

    Article  PubMed  CAS  Google Scholar 

  23. Schmalbach CE, Lowe L, Teknos TN et al (2005) Reliability of sentinel lymph node biopsy for regional staging of head and neck Merkel cell carcinoma. Arch Otolaryngol Head Neck Surg 131:610–614

    Article  PubMed  Google Scholar 

  24. Allen PJ, Busam K, Hill AD et al (2001) Immunohistochemical analysis of sentinel lymph nodes from patients with Merkel cell carcinoma. Cancer 92:1650–1655

    Article  PubMed  CAS  Google Scholar 

  25. Pathak I, O’Brien CJ, Petersen-Schaeffer K et al (2001) Do nodal metastases from cutaneous melanoma of the head and neck follow a clinically predictable pattern? Head Neck 23:785–790

    Article  PubMed  CAS  Google Scholar 

  26. Daugherty HK Jr., Rumboldt T, Hoda RS (2005) Contralateral metastasis of a cutaneous Merkel cell carcinoma: Diagnosis by fine needle aspiration cytology. Diagn Cytopathol 33:450–451

    Article  PubMed  Google Scholar 

  27. Uren RF, Howman-Giles R, Thompson JF (2003) Patterns of lymphatic drainage from the skin in patients with melanoma. J Nucl Med 44:570–582

    PubMed  Google Scholar 

  28. Stadelmann WK, Cobbins L, Lentsch EJ (2004) Incidence of nonlocalization of sentinel lymph nodes using preoperative lymphoscintigraphy in 74 consecutive head and neck melanoma and Merkel cell carcinoma patients. Ann Plast Surg 52:546–549 discussion 550

    Article  PubMed  Google Scholar 

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Correspondence to Virve Koljonen.

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Koljonen, V., Suominen, S. Sentinel node biopsy in local anaesthesia in patients with head and neck Merkel cell carcinoma. Eur J Plast Surg 30, 205–210 (2008). https://doi.org/10.1007/s00238-007-0171-5

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  • DOI: https://doi.org/10.1007/s00238-007-0171-5

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