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Posts Tagged ‘mapping biopsies’

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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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Recurrent SCC of Nasal Tip

HISTORY 71-year-old man presents with recurrence of SCC of nose following Mohs excision on 2-9-17. Partial rhinectomy was performed with incomplete Mohs excision leaving residual positive margins due to patient’s comfort.  Two additional excisions of involved margins were done under anesthesia achieving clear margins. First stage reconstruction was performed on 4-11-18. DISCUSSION Management of a…

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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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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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Twice Recurrent Upper Eyelid SCC

HISTORY 53-year-old man presents with a recurrent upper eyelid induration and margin retraction for 3 months. Punch biopsy confirmed squamous cell carcinoma (SCC) recurrence. The first SCC excision with frozen sections and reconstruction was done 12-17-13 elsewhere. Subsequently, the eyelid was treated with LN2 in 2014 for surface AK. Carcinoma recurred at the lid margin…

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MAPPING OF BCC WITH CONFOCAL MICROSCOPY

        HISTORY 63 year old woman diagnosed with recurrence of BCC of left upper lip in 2015 after treatment of Efudex and a surgical excision in 2005. Patient had 3 separate BCC locations in left upper lip.  Due to the size and multifocality of the lesion, patient was treated with Erivedge for 7…

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CHEEK BASAL CELL CARCINOMA RECURRENCE

Additional soft tissue margin for permanent histology, additional bone margins for permanent histology, partial reconstruction with inferior nasolabial fold/cheek island flap. HISTORY 83 year old man presented in 12/2016 with a 3 month history of a growing painful subcutaneous nodule at the right cheek nasal junction. A biopsy revealed infiltrative basal cell carcinoma. The nodule…

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