Sentinel lymph node biopsy in oral malignant melanoma—a possible means of investigating the clinically node-negative neck

Sentinel node biopsy has been used to determine the presence of nodal metastases in cutaneous melanoma and is being investigated as a tool in patients with oral squamous cell carcinomas. Two patients at Canniesburn Plastic Surgery Unit with oral mucosa malignant melanoma underwent sentinel node biopsy, using a combination of preoperative lymphoscintigraphy to identify lymphatic drainage, the preoperative use of blue dye injection (in one case) and localisation of radioactive nodes with a hand-held gamma probe (in both cases). The first patient presented with a well lateralised anterior tongue melanoma and was found to have “sentinel” nodes on both sides of the neck, all of which were clear of tumour; the second patient had diffuse melanosis of the palate with an invasive component on the left side and was found to have a sentinel node on the right side containing melanin. Our experience suggests that sentinel node biopsy is technically possible for oral melanoma and may be used to investigate the neck of patients with oral melanoma.