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Melanoma

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. Desmoplastic melanoma and spindle cell melanoma are obscure terminology of melanoma subtypes. These represent…

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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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Management of Recurrent Large Melanoma In Situ

HISTORY 78-year-old man presents with a recurrent melanoma in situ of left cheek in April 2018. Previously, the melanoma in situ was excised in 2001. Patient’s dermatologists performed excision in three stages over a period of 3 weeks to achieve clear margins.  Reconstruction of left cheek was performed with a cheek and neck platysma myocutaneous…

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Melanoma within recurrent MIS

HISTORY   73-year-old woman presents with 1-year history of recurrent pigmented lesion of the right nasal ala  found to be invasive melanoma with 0.5 mm invasion. Patient’s history began 9 years ago in 2009 with excision of a melanoma in situ and skin graft closure. In 2012, pigmentation adjacent to the graft site was found…

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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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Forehead Reconstruction 4

Patient diagnosed with Melanoma-In-Situ of central forehead. Forehead reconstruction performed by Dr. Simon Madorksy 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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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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