title: Sentinel lymph node biopsy in the pediatric population.
abstract: BACKGROUND
  Sentinel lymph node biopsy (SLNB) has only been recently used for childhood neoplasms.
  
  
  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, 1 epitheliod, 1 other); 9 skin neoplasms (4 melanomas, 3 Spitz nevi, 2 melanocytomas); and 1 acinic cell carcinoma. All patients underwent Technetium 99m 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 head 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 1 sarcoma). There were no complications in our series, and all patients are alive with no recurrence at an average follow-up of 2.2 years.
  
  
  CONCLUSIONS
  Sentinel lymph node biopsy allows for an accurate biopsy in children. However, some younger patients may require sedation, and it may be more challenging to isolate the sentinel node.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Emory School of Medicine, Atlanta, GA, USA. kenneth.gow@seattlechildrens.org
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Gow
authors.forename: Louis B
authors.initials: LB
authors.lastname: Rapkin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Olson
authors.forename: Megan M
authors.initials: MM
authors.lastname: Durham
authors.forename: Brad
authors.initials: B
authors.lastname: Wyly
authors.forename: Bahig M
authors.initials: BM
authors.lastname: Shehata
mesh_terms: D000293:Adolescent; D018267:Carcinoma, Acinar Cell / Q000175:diagnosis / Q000556:secondary; D002648:Child; D002675:Child, Preschool; D004396:Coloring Agents; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007430:Intraoperative Care; D008207:Lymphatic Metastasis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000556:secondary*; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012394:Rosaniline Dyes; D012509:Sarcoma / Q000175:diagnosis / Q000556:secondary*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology; D013671:Technetium Tc 99m Sulfur Colloid; D055815:Young Adult
chemical_list: D004396:Coloring Agents; D006993:Hypnotics and Sedatives; D019275:Radiopharmaceuticals; D012394:Rosaniline Dyes; C025484:iso-sulfan blue; D013671:Technetium Tc 99m Sulfur Colloid