Melanoma
Treatment Considerations for Melanoma In-Situ
HISTORY A 22-year-old woman presented with left upper lip lesion. Tape testing showed positive for LINC00518 and PRAME. Excisional biopsy was performed showing atypia on the preliminary results. DISCUSSION Management of melanoma in-situ can be especially challenging in cosmetically sensitive areas such as the lip. Traditional management options for melanoma in-situ include surgical excision, topical…
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Managing Lentigo Maligna Melanoma
HISTORY A 56-year-old man presented with complaint of lifelong history of darkening, growing left lesion of the left cheek. Biopsy on 09/24/21 showed melanoma in-situ. Excision with 5-6mm margins and closure of left cheek melanoma performed on 12/2/21 showed positive margins at 3-4 o’clock margins. Woods lamp evaluation and re-excision performed on 1/7/22. DISCUSSION Lentigo…
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A Modern Test for Melanoma
DecisionDx Melanoma is enhancing medical decision making in invasive melanoma stages I, II, and III.. Management of cutaneous melanoma involves strategic risk assessment and oncologic work-up. This typically includes staging, wide local excision, and possible sentinel lymph node biopsy or biologic therapy. Traditionally, surgeons perform a sentinel lymph node biopsy (SLNB) if the possibility of…
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Severe Lichenoid Drug Eruption from Pembrolizumab
HISTORY An 88-year-old woman with a six-month history of a diffuse, pruritic eruption that includes thick, hypertrophic leg lesions with accompanying edema, ulcerations, weeping exudates and pain. The eruption started during a course of pembrolizumab (keytruda) infusions for high risk melanoma of the left great toe. Last Keytruda infusion was three months ago. DISCUSSION Pembrolizumab,…
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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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Evaluation of Longitudinal Melanonychia
HISTORY An 84-year-old woman with a history of melanoma of the left upper back presents with an 11 month h/o left great toe discoloration. Biopsy of left great toe was performed on 08/05/2019. Previous h/o discoloration of the right fifth toe was biopsied and was negative for malignancy. DISCUSSION What is the cause of melanonychia…
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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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Scalp Reconstruction 3
Patient diagnosed with malignant melanoma of midline forehead. Mohs excision performed by primary dermatologist. Forehead/scalp reconstruction performed by Dr. Simon Madorsky at SCARS Center.
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Chin Reconstruction 3
Patient diagnosed with Melanom-In-Situ of left chin. Mohs excision performed at primary dermatologist’s office. Chin reconstruction performed by Dr. Simon Madorsky at SCARS Center.
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Eyelid Reconstruction 4
Patient diagnosed with 0.8 mm invasive melanoma with involved deep margins. Mohs surgery performed by Dr. Matthew Goodman at SCARS Center. Eyelid reconstruction performed by Dr. Simon Madorsky at SCARS Center.
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