Posts by Simon Madorsky, MD
Multiple Cutaneous Carcinomas in Organ Transplant Recipients
HISTORY A 73-year-old kidney transplant recipient presented with multiple carcinomas including SCC, SCC in situ, and BCC of the face and scalp. DISCUSSION Organ transplant recipients can suffer from multiple cutaneous carcinomas. Some lesions can have a high risk of metastases, but most occur in multitudes in areas of extensive sun exposure. At SCARS Center,…
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Desmoplastic / Spindle Cell Melanoma of the Scalp
A 67-year-old man with CLL presents with 3 month h/o 3 cm dense dermal growing scalp mass. Incisional biopsy showed spindle cell melanoma. The tumor was resected with a 2 cm margin. Final pathology showed malignant melanoma—spindle cell / desmoplastic type. Additional 1.2 cm margin was resected for wide clearance creating a 10 x 9…
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Dermatofibroma to Dermal Sarcoma: The Spectrum of Dermal Spindle Cell Tumors
HISTORY A 54-year-old woman with no history of skin cancers presented with 4 month h/o growing left cheek nodule. After a shave biopsy that suggested a dermatofibroma, the tumor progressed to ulceration . A 74-year-old man presented with a 2 month h/o bleeding, ulcerated nodule of left antitragus. He has a history of several skin…
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Intralesional 5-fluorouracil for Cutaneous BCC and SCC
HISTORY An 86-year-old man on hemodialysis with multiple medical problems and on warfarin presented with two carcinomas of the nasal tip: BCC of the left nasal tip and SCC of the right nasal tip. The ulceration of the right SCC exposed the alar cartilage. Patient completed six (6) 5-fluorouracil injections over a 5-week period. Complete…
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Nasal Open Wound Complication
HISTORY A 73-year-old man with BCC of the nasal tip presented 1 week following Mohs excision. His reconstruction was delayed for an additional week for a cardiac work up. Nasal reconstruction was performed with a superior extended nasal myocutaneous flap (SENMI flap) and nasal septal cartilage grafts. The patient developed nasal tip incisional discharge 1…
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Sentinel Lymph Node Biopsy for Cutaneous SCC
HISTORY A 58-year-old kidney transplant recipient presented with a 6-month history of squamous cell carcinoma of the left scalp. This large lesion was adjacent to the scar of a previous carcinoma excision in 2014. Patient is on sirolimus for his kidney transplant performed in 1984. He has had multiple BCCs and SCCs of scalp, back,…
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Near-Infrared Laser Lymphangiography Sentinel Lymph Node Biopsy for Melanoma
HISTORY A 61-year-old male presents for 1.5 cm malignant melanoma of left posterior shoulder invading to at least 1.2 mm (Clark’s Level IV) on a shave biopsy. Left shoulder melanoma was excised, and a left axillary sentinel lymph node was biopsied. Small focus of residual melanoma was found in the primary site, but none in…
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Atypical Nevus – a Melanoma Precursor? Not Exactly
HISTORY A 27-year-old woman presented with many-year history of left cheek nevus. The lesion grew in size and changed in color. Shave biopsy showed a nevus with moderate atypical melanocytic hyperplasia. Residual pigmentation of the nevus and involved histologic margins remained after the biopsy. DISCUSSION Are all atypical melanocytic lesions pre-melanomas? Should dysplastic lesions be…
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Pediatric Office Procedures with PRO-NOX™ Nitrous Oxide
HISTORY An 8-year-old girl presents with a 1 year history of dark mole of the right lower eyelid. Initially presenting as a small freckle, it grew and darkened in color. Right lower eyelid excisional biopsy was performed utilizing PRO-NOX™ nitrous oxide system. Biopsy showed intradermal nevus, combined type (primarily a common blue nevus and a…
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Nasal Skin Graft Revision with Flaps
HISTORY The patient presented for scar revision 8 months after Mohs excision of BCC of the nose and closure with an ear skin graft, performed elsewhere. Patient presents for correction of the atrophic erythematous skin graft scar. The patient was treated with two signature flaps of the SCARS Center developed for nasal reconstruction. DISCUSSION The…
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