Michiel W.M. van den Brekel*, Charlotte A.H. Lange, Wouter V. Vogel, Marianne B. Crijns, Remco de Bree and Charlotte L. Zuur
Abstract:
In this review summarizes the workup and management of the N0 neck in head and neck Merkel cell carcinomas, melanomas and aggressive squamous cell carcinomas (SCC) of the skin. Of all imaging modalities, ultrasound guided aspiration cytology (US-FNAC) has the highest accuracy. CT, MRI as well as PET-CT have a lower accuracy, mainly because of a lower specificity. The sensitivity of all modalities is in the range of 50-60%. Recently published literature suggests that in high-risk skin cancers either elective treatment or sentinel node procedures are the way to go. Sentinel node biopsies (SNB) can have a very high sensitivity, but only when performed by well trained surgeons and using modern guidance systems such as SPECT, intraoperative scintigraphy and fluorescence. The most logical routine approach in high-risk skin cancer is to select patients for SNB using US-FNAC.
In this review summarizes the workup and management of the N0 neck in head and neck Merkel cell carcinomas, melanomas and aggressive squamous cell carcinomas (SCC) of the skin. Of all imaging modalities, ultrasound guided aspiration cytology (US-FNAC) has the highest accuracy. CT, MRI as well as PET-CT have a lower accuracy, mainly because of a lower specificity. The sensitivity of all modalities is in the range of 50-60%. Recently published literature suggests that in high-risk skin cancers either elective treatment or sentinel node procedures are the way to go. Sentinel node biopsies (SNB) can have a very high sensitivity, but only when performed by well trained surgeons and using modern guidance systems such as SPECT, intraoperative scintigraphy and fluorescence. The most logical routine approach in high-risk skin cancer is to select patients for SNB using US-FNAC.
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