Call Us Today:
949.200.1600

Patient Case Studies

SCC of Scalp

SCC-Scalp-Newport-Beach-Mohs-and-Reconstruction-perineural-invasion

HISTORY 86-year-old man presents with 3-month history of a mass in the left occipital scalp. 1 year prior, the patient underwent Mohs excision of a large scalp SCC.  FNA biopsy on 1-22-18 found atypical squamous cells. CT PET scan showed cancer limited to the mass itself with no lymph node enhancement. Patient experienced progressively increasing…

Read More

Shave excision of Lower Extremity Carcinomas

Basal-cell-carcinoma-shave-excision-skin-cancer-orange-county-shave-excision-dermablade

HISTORY 67-year-old woman presents with 3 BCCs on right lower extremity diagnosed on shave biopsies.  Superficial shave excisions of the carcinomas left close margins within 0.1 mm. Second set of shave excisions found no residual carcinoma.     DISCUSSION Lower leg skin carcinomas are often superficial and can be treated with superficial treatments. This patient’s…

Read More

Mitoses in a Dysplastic Nevus

Dysplastic-nevus-melanocytic-tumor-porcine-xenograft-island-flap2

HISTORY 61-year-old man presents with 6-month history of forehead lesion. Biopsy on October 2017 showed atypical nevomelanocytic neoplasm with several mitoses (3/mm2).  An excision with 5 mm margins was performed in November 2017 with negative findings. DISCUSSION This melanocytic tumor of uncertain malignant potential can also be called a MELTUMP. These lesions present a treatment…

Read More

Adnexal Squamous Cell Carcinoma Recurring in Parotid

adnexal-squamous-cell-carcinoma-parotid-Mohs-and-reconstruction2

HISTORY 74-year-old woman presents with a third occurrence of poorly differentiated carcinoma of the left cheek. Her history began in March 2015 with a 1 cm left cheek dermal poorly differentiated carcinoma. Histologic differential diagnosis included metatypical basal cell carcinoma, adnexal BCC, or metastatic epidermoid origin carcinoma. CT/PET scan was negative at the time. She…

Read More

Myxoid Lipoma of Scalp

myxoid-lipoma-scalp-soft-tissue-mass-skin-dermatopathology

HISTORY 61-year-old man presents with 40 year history of 2.5 cm mobile lipoma on left scalp vertex. Ultrasound performed on 11-14-17 revealed lipoma. Results from excision of mass showed myxoid lipoma. Consultation was obtained with Emory’s Sharon Weiss, MD, a soft tissue pathology expert.     DISCUSSION The benign myxoid lipoma should be differentiated from the malignant…

Read More

Dysplasia of Lower Lip

Dysplasia-lower-lip-actinic-cheilitis-skin-cancer-SCC

HISTORY 51-year-old man presents with one-year history of lower lip nonhealing lesion. The patient has a many year history of extensive sun exposure with scaling and crusting.  A biopsy of the nonhealing lesion showed leukokeratosis with minimal keratinocytic atypia. Excisional biopsy done 11-1-17 showed moderate to focally severe squamous atypia. The patient was then treated…

Read More

Lower Leg Wound Dehiscence

Lower Leg Wound Treatment At Scars Center

HISTORY 74-year-old man presents with BCC of left lower leg treated with Mohs excision and closure on 2-27-18. Patient presented 5 days post closure with wound dehiscence. Cutimed wound sponge dressing was used for wound management.  Debridement was performed 3-16-18. Plan is for closure with matrix xenograft.       DISCUSSION Lower leg wound dehiscence…

Read More

Multiple Skin Cancers in an Organ Transplant Recipient

Treatment for Multiple Skin Cancer Patients

HISTORY 71-year-old organ transplant recipient presents with several SCC’s of scalp and face. Mohs excisions and closures were performed.  Tissue of the left temple incidental to reconstruction was submitted for histologic analysis. Incidental BCC was found in the specimen requiring additional treatment. 4 to 6 o’clock margin was involved.   The patient with bilateral kidney…

Read More

BCC Left Upper Lip

BCC-Left-Upper-Lip-Orange-County-Skin-Cancer-Mohs-Reconstruction

HISTORY 87-year-old man presents with 1 year history of lesion on left upper lip.  Biopsy taken 11-16-2017 and pathology showed basal cell carcinoma. Mohs excision and reconstruction were performed on 1-19-18. Mohs slide histology was presented for review. A question of appearance of perineural invasion was discussed.       DISCUSSION   The Mohs slides…

Read More

Left Cheek Atypical Spitzoid Nevus

Atypical-Spitzoid-Nevus-Histology-Orange-County-Skin-Cancer2

HISTORY 23-year-old woman presents with lifelong history of left cheek mole changing recently. Biopsy in 8/2017 showed compound nevus with severe atypia with spitzoid features. Excision was performed on 2-9-18. The patient a history of atypical mole of the left back removed in 2017.       DISCUSSION   Spitz nevi are are spindle /…

Read More