Sentinel lymph node biopsy for squamous cell carcinoma of the extremities: case report and review of the literature.

BACKGROUND Lymph node metastases from squamous cell carcinoma (SCC) can reach 20% in some high risk subgroups, and while early detection of metastasis may potentially improve overall and/or disease-specific survival, techniques for early detection have not been established. One such technique is the use of sentinel lymph node biopsy (SLNB), however its role for SCC of the extremities has not been explored. MATERIALS AND METHODS A case that highlights the utility of SLNB in this setting is described, and a systematic review of the literature was undertaken in order to establish the current evidence for its use. RESULTS There have been no prospective clinical trials performed to investigate the role of SLNB in this setting. Thirty-two cases utilizing SLNB for peripheral SCCs have been reported, with a 28.1% rate of positive SLN, and low false-positive and false-negative rates. No complications were reported. CONCLUSION SLNB for SCC of the limbs has been scarcely reported, but those cases reported do collectively demonstrate a high positive predictive value for lymph node metastasis and a low false-positive rate, with poor prognostic variables identified. The efficacy of SLNB in this setting requires further investigation.