Posts by Simon Madorsky, MD
Cheek Reconstruction 2
Basal Cell Carcinoma of cheek. Treatment Mohs surgery. Reconstruction by Simon Madorsky, MD at SCARS Center.
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Cheek Reconstruction 1
Squamous Cell Carcinoma of cheek. Treatment radiation therapy, Mohs surgery coordinated with primary dermatologist at SCARS Center, and reconstruction by Simon Madorsky, MD.
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Melanoma In Situ of Leg – Mapping Excision Margins
The vexing problem of positive margins after excision of melanoma in situ has many solutions. In this article, we summarize them and rank them in the order of efficacy. Melanoma in situ excision margin guidelines range from the older 5 mm margin to the aggressive 10 mm margin of resection. 7 mm seems to…
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Mapping of Recurrent Melanoma In Situ of Leg
HISTORY 50-year-old woman presents with recurrent melanoma in situ of left leg. First biopsied on 9-2-16, the lesion was excised on 10-14-16 and showed extensive residual melanoma in-situ with radial margins involved from 12- 3 o’clock. The defect was reconstructed at the time with a full thickness skin graft. Second excision cleared the involved…
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Left Ear Multiple Recurrent Basal Cell Carcinoma
HISTORY 64-year-old woman presents with recurrence of left ear basal cell carcinoma. She has a history of sun lamp tanning and scuba diving with multiple sun burns. Basal cell carcinoma was first removed from left scapha and treated with a skin graft in July 2009. The area subsequently developed crusting and was treated with…
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Hand SCC In Situ
HISTORY 68-year-old woman presents with a many month history of squamous cell in situ of left hand. This large 2.5 cm lesion on the hand poses a unique challenge to ensuring hand function post-operatively. Treatment options include C&D (curettage and desiccation), curettage only with post-treatment imiquimod, Mohs excision with a skin graft closure, or superficial…
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Right Ear Melanoma In Situ with Depth Uncertainty – The role of Histopathologic Discordance in Clinical Decision Making
HISTORY 40-year-old man presents with a 2 month history of right posterior ear pigmented papule. Shave biopsy on 9-18-17 showed malignant melanoma at least in situ. Excision with 5 mm margins on 10-9-17 confirmed residual melanoma at least in situ with clear margins. DISCUSSION Lack of superficial invasion cannot be definitely ruled out after a…
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BCC Presenting as a Back Keloid
HISTORY 80-year-old man presents with 2-year history of back nodule believed to be a keloid from a spider bite. The patient has a history of multiple basal cell carcinomas. DISCUSSION Biopsy showed this lesion to be a basal cell carcinoma. Moral of the story is that not all keloids or spider bites are what…
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Chasing Margins of Melanoma In Situ of Back
HISTORY 69-year-old man presents with melanoma in situ of the upper back. A biopsy on 6/15/2017 showed malignant melanoma at least in-situ. Excision with 5 mm margin and skin graft closure on 8/9/2017 found residual melanoma in situ with at 2-4 o’clock. Additional 4mm margin excision on 9-13-17 still found residual lesion at 1-3…
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Rhinophyma
HISTORY 65-year-old man with a history of BCC presented with a 4-year history of growing inflamed rhinophyma. First rhinophyma excision was done on 04-01-2013. Recurrence of rhinophyma resulted in the second excision and nasal planing procedure on 06-16-17. Pathology showed no evidence of malignancy. DISCUSSION Our approach to rhinophyma is based on sculpting of the…
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