Sentinel Lymph Node Biopsy for Cutaneous Squamous Cell Carcinoma of the Head and Neck

Inclusion Criteria:

* Patients ≥ 18 years old at the time of informed consent
* Ability to provide written informed consent and HIPAA authorization
* Primary or recurrent invasive cutaneous squamous cell carcinoma of the head or neck, clinically staged T2-T4 based on AJCC staging
* Clinically and radiographically regional node-negative (no evidence of regional lymph node metastasis or distant metastasis)
* Able to undergo general anesthesia for sentinel lymph node biopsy
* Able to undergo CT scan with contrast or MRI with contrast
* Undergo surgical resection (Moh's or micrographic resection or standard excision with sentinel lymph node biopsy) within 8 weeks of imaging

Exclusion Criteria:

* Clinical evidence of satellite lesions, in-transit, regional nodal or distant metastases
* Known biopsy proven synchronous primary cutaneous squamous cell carcinoma
* Pregnant patients
* Patients unable to undergo general anesthesia
* Patient unable to receive contrasted imaging studies
* Patient unable to receive and/or allergic to 99m-Technetium sulfur colloid