Call Us Today:
949.200.1600

Excision with Frozen Section

Home > Treatment > Surgical Treatment >  Excision with Frozen Section

Skin-Cancer-Specialists-Skin-Cancer-Treatment-Excision-with-frozen-section-Skin-Cancer-and-Reconstructive-Surgery-Center-Orange-County

ABOUT EXCISION WITH FROZEN SECTION

An excision with frozen sections is a procedure in which skin cancer is removed and the tissue specimen is then frozen. Next, several cuts are made through the frozen tissue, stained with special dyes and inspected by a pathologist or dermatopathologist for tumors cells near the surgical cut margin. This process is repeated until no tumor cells are present under the microscope. There is only a 95% accuracy rate because the skin cancer is not mapped out and only isolated areas are examined. This means in about 5% of cases, tumor cells may be present a few days after the procedure and requires further treatment.

EXCISIONAL SURGERY WITH CONVENTIONAL FROZEN SECTION MARGIN CONTROL

Often performed in a hospital setting, this surgical procedure involves checking the pathology with frozen sections prior to closing the surgical wound. Additional tissue is removed prior to closing the wound If the tumor extends to the edges of the specimen.

ADVANTAGES AND DISADVANTAGES OF EITHER MOH'S OR RAPID FROZEN SECTION TREATMENT

Moh's micrographic surgery has the advantage of a more accurate initial analysis of the tissue. In areas such as the face, nose, or where preservation of skin is important for reconstruction this is especially of value. The main disadvantage of Moh's is that it might take several hours to complete or you may have days between excision (removal of skin cancer) and reconstructive surgery to close the defect. Especially in areas of the face and body which have plenty of skin available for reconstruction, Moh’s micrographic surgery is often unnecessary and time consuming.

VARIOUS REASONS FOR USING THE FROZEN SECTION TECHNIQUE

If a tumor appears to have spread (metastasized), a sample is sent for frozen section for confirmation. This helps when determining whether there is any point in continuing the operation. Usually, surgical excision is performed only if there is a chance to remove all cancer. If the tumor has spread, a more conservative approach is taken.

 

If a tumor has been removed but it is unclear whether the margin (border) is clear, frozen section is used to determine if further resection is needed for clear margins.

 

In a sentinel lymph node biopsy, frozen section can help determine whether the sentinel node containing tumor tissue requires further lymph node dissection, while a benign node will avoid such a procedure.

Related Articles

Recurrent BCC of the External Ear After Radiation
HISTORY A 77-year-old man presents with 5-year history of infiltrative basal cell carcinoma (BCC) of the left ear fossa triangularis and root of helix. The area was originally treated with four weeks of radiation in 2014, complicated by temporary ulceration and healing with adhesion. When the area developed crusting a couple of years later, the…
Read More
Lethal Squamous Cell Carcinoma of the Forearm in a Lung Transplant Recipient
HISTORY A 71-year-old lung transplant recipient presented with a recurrence of left dorsal forearm and wrist Squamous Cell Carcinoma (SCC) after Mohs excision in 2016 performed elsewhere. The patient underwent Mohs excision with clear margins and additional deeper wide local resection with no carcinoma identified. Patient was referred for radiation oncology evaluation, but he was…
Read More
trichoepithelioma-histology-lateral-nasal-island-orange-county-skin-cancer-desmoplastic-series
Trichoepithelioma
HISTORY 33-year-old woman presents with 3-year history of slowly growing nasal tip lesion biopsied as a trichoepithelioma. Mohs excision was performed creating a 0.6 cm defect. It was reconstructed with a lateral nasal island flap. DISCUSSION Trichoepithelioma is a benign basaloid follicular neoplasm (arising from a pilosebaceous unit). Its basal cell proliferation is differentiated from…
Read More
recurrent-bowens-disease-squamous-cell-carcinoma-topical-chemotherapy
Recurrent Bowen’s Disease of Temple
HISTORY 63-year-old man presents with 9-month history of Bowen’s disease of right anterior and posterior sideburn biopsied on 08-20-18. History of previous Mohs excision of Bowen’s disease of the same area in February 2016. Patient has a history of multiple basal cell carcinomas, squamous cell carcinomas, and melanoma. DISCUSSION Management of this lesion is best…
Read More
scleromyxedema-cutaneous-lesions-dermatopathology-spindle-cell-basal-cell-carcinoma
Scleromyxedema Cutaneous Lesions
HISTORY 87-year-old man with underlying scleromyxedema and history of multiple basal cell carcinomas presents with a left earlobe nodule. Biopsy revealed this to be a lesion with benign spindle cell proliferation in vague concentric whorls with associated dermal fibrosis and chronic inflammation. This was a typical scleromyxedema lesion presenting within the fatty earlobe and not…
Read More
cystic-squamous-cell-carcinoma-of-forearm-keratoacanthoma-dermatopathology
Cystic Squamous Cell Carcinoma of Forearm Skin
HISTORY 74-year-old man presents with 3-month history of painful lesion of the right forearm.  Biopsy found cystic squamous cell carcinoma with deep margins involved. Wide local excision was performed achieving clear margins. DISCUSSION Cystic degeneration within squamous cell carcinoma of the skin is not considered an especially malignant finding. These histologic findings may represent changes…
Read More

STAY UP TO DATE

Receive research updates, inspiring stories, healthy living tips and more.

Something went wrong. Please check your entries and try again.

FOLLOW US

ELEVATING THE STANDARDS OF SKIN CANCER MANAGEMENT.

© 2018 SCARS Management Services. All rights reserved.