Call Us Today:
949.200.1600

Excision with Frozen Section

Home > Treatment > Surgical Treatment >  Excision with Frozen Section

Skin-Cancer-Specialists-Skin-Cancer-Treatment-Excision-with-frozen-section-Skin-Cancer-and-Reconstructive-Surgery-Center-Orange-County

ABOUT EXCISION WITH FROZEN SECTION

An excision with frozen sections is a procedure in which skin cancer is removed and the tissue specimen is then frozen. Next, several cuts are made through the frozen tissue, stained with special dyes and inspected by a pathologist or dermatopathologist for tumors cells near the surgical cut margin. This process is repeated until no tumor cells are present under the microscope. There is only a 95% accuracy rate because the skin cancer is not mapped out and only isolated areas are examined. This means in about 5% of cases, tumor cells may be present a few days after the procedure and requires further treatment.

EXCISIONAL SURGERY WITH CONVENTIONAL FROZEN SECTION MARGIN CONTROL

Often performed in a hospital setting, this surgical procedure involves checking the pathology with frozen sections prior to closing the surgical wound. Additional tissue is removed prior to closing the wound If the tumor extends to the edges of the specimen.

ADVANTAGES AND DISADVANTAGES OF EITHER MOH'S OR RAPID FROZEN SECTION TREATMENT

Moh's micrographic surgery has the advantage of a more accurate initial analysis of the tissue. In areas such as the face, nose, or where preservation of skin is important for reconstruction this is especially of value. The main disadvantage of Moh's is that it might take several hours to complete or you may have days between excision (removal of skin cancer) and reconstructive surgery to close the defect. Especially in areas of the face and body which have plenty of skin available for reconstruction, Moh’s micrographic surgery is often unnecessary and time consuming.

VARIOUS REASONS FOR USING THE FROZEN SECTION TECHNIQUE

If a tumor appears to have spread (metastasized), a sample is sent for frozen section for confirmation. This helps when determining whether there is any point in continuing the operation. Usually, surgical excision is performed only if there is a chance to remove all cancer. If the tumor has spread, a more conservative approach is taken.

 

If a tumor has been removed but it is unclear whether the margin (border) is clear, frozen section is used to determine if further resection is needed for clear margins.

 

In a sentinel lymph node biopsy, frozen section can help determine whether the sentinel node containing tumor tissue requires further lymph node dissection, while a benign node will avoid such a procedure.

Related Articles

Dysplastic-nevus-melanocytic-tumor-porcine-xenograft-island-flap2
Mitoses in a Dysplastic Nevus
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-parotid-Mohs-and-reconstruction2
Adnexal Squamous Cell Carcinoma Recurring in Parotid
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-scalp-soft-tissue-mass-skin-dermatopathology
Myxoid Lipoma of Scalp
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
cerclage-closure-skin-cancer-Mohs-and-reconstruction-orange-county-
Cerclage Closures
DISCUSSION Cerclage closure is a relatively straightforward approach to wound repair in certain locations. Body regions with no appreciable skin creases or relaxed skin tension lines are good candidates for this technique. Regions with inherently high tension of closure is all directions, such central chest and convex shoulder, heal better with a cerclage scar versus…
Read More
Dysplasia-lower-lip-actinic-cheilitis-skin-cancer-SCC
Dysplasia of Lower Lip
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 Treatment At Scars Center
Lower Leg Wound Dehiscence
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

STAY UP TO DATE

Receive research updates, inspiring stories, healthy living tips and more.

Something went wrong. Please check your entries and try again.

FOLLOW US

ELEVATING THE STANDARDS OF SKIN CANCER MANAGEMENT.

© 2018 SCARS Management Services. All rights reserved.