Sentinel Node Biopsy detecting occult Metastasis on early stage Tongue Cancer: Case Report and Surgical technique

Author(s): Tiago Mendes, Ricardo Nogueira, Carlos Zagalo, Miguel Vilares, Pedro Gomes

Introduction: The sentinel node biopsy (SNB) technique is rapidly gaining recognition in the field of oncology, particularly for head and neck carcinomas in the detection of occult cervical metastases, with the potential to avoid unnecessary neck dissections. Tongue carcinoma has a high capacity for metastasis and a greater potential for the application of this technique.

Presentation of case: A 57-year-old woman presented with a tongue lesion without evident clinically node metastasis, compatible with an early squamous cell carcinoma. She was submitted to a sentinel node biopsy with identification of a metastasis in the sentinel node.

Discussion: The implementation of SNB in tongue carcinoma faces significant resistance, as there are no sustained data regarding its validation and reproducibility in the head and neck. The gold-standard treatment consists of elective neck dissection, which is associated with a large number of unnecessary neck dissections and consequent morbidity.

Conclusion: This study case supports the validity of the SNB technique as an effective method for detecting occult metastases in early-stage tongue carcinoma.