Conjunctival melanoma metastasis diagnosed by sentinel lymph node biopsy

Evaluate the use of sentinel lymph node biopsy (SLNB) in staging and directing treatment of patients with conjunctival malignancy. Retrospective, noncomparative, interventional case reports. Two patients with conjunctival melanoma underwent SLNB, which consisted of lymphoscintigraphy with injection of sulfur colloid technetium-99m. Lymphazurin blue was injected intraoperatively into the area of prior excision. The combination of a signal through the sulfur colloid technetium-99m and blue staining identified SLNs. In both patients, the SLNs containing metastatic disease were identified and biopsies obtained, aiding staging and optimal therapy. Sentinel lymph node biopsy has been recently reported as an aid in evaluating patients with periocular malignancies. These reports of patients with tumor-positive SLNs arising from the lymphatic metastasis of conjunctival malignancies underscore the utility of this important technique in evaluating patients with periocular malignancies.