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Sentinel lymph node biopsy: a new perspective in head and neck mucosal melanoma?

Both of our cases have remained without any evidence of lymphatic disease since their initial negative sentinel node biopsy. This is despite two episodes of local recurrence in one case. Mucosal melanoma is known to have a local recurrence rate as high as 50% [3]. This highlights one of the potential issues of the use of sentinel node biopsy in this disease as patients may have several episodes of local recurrence without lymphatic disease. We have elected not to perform repeat sentinel node biopsy with each episode of local recurrence but to monitor the patients clinically for evidence of disease. Mucosal melanoma is a rare disease and because of this it will be difficult to build an evidence base to support the use of sentinel node biopsy to stage the regional lymph node basins. Despite this, local-regional control is associated with a higher likelihood of long-term survival and for this reason the use of this technique merits further investigation [4,5].