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Posts Tagged ‘melanoma in situ’

Atypical Nevus – a Melanoma Precursor? Not Exactly

HISTORY A 27-year-old woman presented with many-year history of left cheek nevus. The lesion grew in size and changed in color. Shave biopsy showed a nevus with moderate atypical melanocytic hyperplasia. Residual pigmentation of the nevus and involved histologic margins remained after the biopsy. DISCUSSION Are all atypical melanocytic lesions pre-melanomas? Should dysplastic lesions be…

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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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Right Ear Melanoma in Situ - Treatment

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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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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RECURRENT MELANOMA

  HISTORY 70-year-old woman presents with metastatic melanoma in the right parotid gland region of 1 year duration. Diagnosis was made with a core needle biopsy on 09-08-17. Patient also has small palpable right cervical lymph nodes with SUV 1.6 and 2.0. Patient history of melanoma began in 2001 as a pink macule of the…

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CHEEK AND EYELID RECONSTRUCTION WITH MULTIPLE PARTIAL ISLAND FLAPS

HISTORY 61-year-old woman presents with several year history of pigmented left cheek and lower lid lesion.  She was initially treated with liquid nitrogen 15 months ago. A biopsy was performed 6-8-17 and revealed melanoma in situ. Excision with close margins performed 6-16-17. Clear margins found on LPMG reading. Second opinion from UCSD was suspicious for…

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ADDITIONAL MARGIN EXCISION AFTER SKIN GRAFTING

DISCUSSION This series of photographs represents an approach to margin management of melanoma in situ. Some melanoma in situ margins are difficult to assess clinically, as is the case in our first series with extensively pigmented skin. In some settings, taking 7-9 mm margins exposes the patient to significant healing issues, as the second case…

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Radical Excision of Melanoma in Situ

Acceptance of Residual Melanoma-In-Situ: Avoiding Cosmetic and Functional Deformation

Acceptance of residual melanoma-in-situ (lentigo maligna) after an excision can avoid cosmetic and functional deformation. Is the residual risk of recurrence and transformation into invasive melanoma low enough to warrant observation? Melanoma-in-situ (MIS) is a high risk lesion due to three primary reasons. The first is that a partially biopsied melanocytic lesion with a diagnosis…

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Melanoma-in-situ of the Chin

A middle-age man with previous melanoma-in-situ of the back presents with new chin lesion biopsied as melanoma-in-situ on a deep shave biopsy. Subsequent surgical excision with 2 mm margins revealed no evidence of residual melanoma. Observation was chosen as the course of management. Should additional wider margin resection be performed? Melanoma-in-situ (MIS) is a high…

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