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Posts by Simon Madorsky, MD

Melanoma-in-situ of the Chin

A middle-age man with previous melanoma-in-situ of the back presents with new chin lesion biopsied as melanoma-in-situ on a deep shave biopsy. Subsequent surgical excision with 2 mm margins revealed no evidence of residual melanoma. Observation was chosen as the course of management. Should additional wider margin resection be performed? Melanoma-in-situ (MIS) is a high…

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Perineural Invasion

Perineural invasion is strongly indicative of aggressive behavior and risk of metastases. True perineural invasion requires histologic finding of cancer invasion of the nerve or cancer invasion of the epineurium adjacent to the nerve.  This must be distinguished from cancer near a nerve, cancer encompassing a nerve, and perineural inflammation. Cancer cells within the nerve…

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