Sentinel Lymph Node Biopsy for Eyelid and Conjunctival Malignancies

In the 1990s, the technique of sentinel lymph node(SLN) biopsy was developed as a less morbid alternative to elective lymphadenectomy. SLN biopsy is based on the principle that cutaneous lesions drain to the regional lymph nodes before metastasizing distantly and that the disease status of the first node or first few nodes in the lymphatic chain to which the tumor drains carries valuable prognostic information. As many malignancies in the periocular region have the potential to metastasize to the regional lymph nodes, sentinel lymph node biopsy has been evaluated for identification of early microscopic lymph node metastasis in patients with cancers of the eyelid and conjunctiva. This chapter summarizes the anatomic and technical considerations and indications for SLN biopsy in the periocular region and will review the published reports to date on this topic and important relevant recent reports on sentinel lymph node biopsy in general and also on implications for adjuvant therapy particularly for melanoma patients.