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Sentinel lymph node biopsy for conjunctival melanoma.

B Esmaeli¹, S Eicher, J Popp

¹Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.

Ophthalmic Plastic and Reconstructive Surgery

|January 5, 2002

Summary

Preoperative lymphoscintigraphy and sentinel lymph node (SLN) biopsy is a safe and feasible procedure for conjunctival melanoma. This technique successfully identified SLNs with no immediate adverse effects, paving the way for further sensitivity studies.

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Area of Science:

Ophthalmology
Surgical Oncology
Nuclear Medicine

Background:

Conjunctival melanoma is a rare malignancy.
Accurate staging is crucial for effective treatment and prognosis.
Sentinel lymph node (SLN) biopsy is a standard procedure for staging cutaneous melanoma, but its role in conjunctival melanoma is less established.

Observation:

A case study involving a 49-year-old male with conjunctival melanoma.
Preoperative lymphoscintigraphy and SLN biopsy were performed using isosulfan blue dye and technetium Tc 99 m sulfur colloid.
The SLNs were successfully identified and excised, with subsequent histological and immunohistochemical analysis.

Findings:

Three SLNs were accurately identified and located in the submandibular and jugular lymph node basins.

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All identified SLNs were histologically negative for melanoma metastasis.

No immediate adverse effects on the ocular or periocular structures were observed.

Implications:

Preoperative lymphoscintigraphy and SLN biopsy appear to be a safe and feasible method for staging conjunctival melanoma.
This technique holds promise for detecting occult regional nodal disease.
Further larger studies are warranted to establish the sensitivity and clinical utility of this approach in conjunctival melanoma management.