[Scintillation probe guided sentinel lymphadenectomy in malignant melanoma]

In cutaneous melanoma, biopsy of the first tumor-draining lymph node (Sentinel node, SLN) may replace routine elective lymph node dissection (ELND). The SLN has been shown to contain the first micrometastasis in early lymphatic tumor dissemination. As micrometastases were identified in 10-30% of stage I (AJCC/UICC) patients, sentinel lymphonodectomy (SLND) should enable us to select patients clinically in stages I and II, but histopathologically in stage III. This optimization of patient selection is mandatory as only this subgroup profits from ELND. Since the beginning of 1995 we was scintillation detector (gamma probe)-guided sentinel biopsy in patients with a melanoma > 1.0 mm and clinically negative lymph nodes. After injecting colloidal 99m-Tc-labelled tin(II)-sulfide solution around the tumor (or the biopsy scar), the SLN can be localized exactly. The technique is minimally invasive and easy to handle. If the SLN contains tumor, a standard en bloc lymphonodectomy is performed. Long-term follow-up, however, is needed to delineate the role of this procedure in melanoma treatment.