Sentinel lymph node biopsy in the pediatric population

Background: Sentinel lymph node biopsy (SLNB) has only been recently used for childhood neoplasm. Methods: We reviewed all patients younger than 19 years who underwent SLNB for 5 years. Results: Twenty patients were identified (11 male, 9 female). Sentinel lymph node biopsy was performed for 10 sarcomas (5 synovial, 3 rhabdomyosarcoma, I epitheliod, I other); 9 skin neoplasms (4 melanomas, 3 Spitz nevi, 2 melanocytomas); and I acinic cell carcinoma. All patients underwent Technetium 99111 Sulfur microcolloid injection and 4-quadrant subdermal injection with Lymphazurin 1% (Autosuture, Norwalk, Conn). Six patients required either sedation for lymphoscintigraphy. Intraoperative gamma probe was used. Primary lesions were found in lower extremity (n = 8), upper extremity (n = 6), trunk (n = 3), and]lead and neck (n = 3). The lymphatic basins were inguinal (n = 8), axilla (n = 8), neck (n = 3), and both inguinal and axilla (n = 1). At least one lymph node was identified in each procedure. Of 20 patients, 5 (25%) had metastatic disease (4 skin neoplasms and I sarcoma). There were no complications in our series, and all patients are alive with no recurrence at ail average follow-up of 2.2 years. Conclusions: Sentinel lymph node biopsy allows for ail accurate biopsy in children. However, some younger patients may require sedation, and it may be more challenging to isolate the sentinel node. (C) 2008 Elsevier Inc. All rights reserved,