Posts Tagged ‘Skin Cancer Connection’
Subtotal Ear Reconstruction with Alloplast
DISCUSSION Subtotal ear reconstruction is a challenging surgical task that often requires non-traditional techniques. This particular patient was treated with an alloplastic implant and rib cartilage grafts. We utilized Medpor Helical Rim implant, a porous polyethylene material (Stryker, USA) used for microtia reconstruction. The implant was used for its elegantly curved helix. The rib cartilage…
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Total Ear Reconstruction with Osseointegrated Prosthesis
DISCUSSION Total ear reconstruction after radical skin cancer resection can be treated with prosthetic rehabilitation. Optimally, osseointegrated fixation of a prosthesis is employed. This patient was treated with complete ear amputation and post-operative radiation. His prosthetic rehabilitation was a team effort between Simon Madorsky, M.D., at SCARS Center and Mark George, D.D.S., a prosthodontist. Three…
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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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Upper Chest BCC PNI
HISTORY 53-year-old man presents with a 4-year-history of BCC of upper chest. The tumor measured 12 cm x 6 cm. Wide local excision with 1 cm margins on 11/10/2017 found clear margins and perineural invasion. The nerves up to 0.23 mm were involved by tumor. The final defect was 13.5 cm x 8.3 cm. …
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Multiple Nasal Basal Cell Carcinomas
HISTORY 81-year-old man presents with 7-month history of two nasal tip and right nasal ala BCC’s. All three lesions were treated with 2 adjoining SRT fields. The course began 1-8-18 and completed by 1-26-18 after 15 treatments. DISCUSSION This patient represents an excellent candidate for radiation therapy. Electron beam radiation therapy can be used with…
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Large Thigh BCC Treated with Radiation
HISTORY 92-year-old man presents with 15-year history of basal cell carcinoma on left thigh. The 9.3 cm x 8.6 cm superficial plaque was treated with electron beam radiotherapy completing 6000 cGy in 30 fractions on 3-13-2018. DISCUSSION The 6-week course of radiation was tolerated well by this patient. He had minimum oozing from previous biopsy…
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Left Cheek Atypical Spitzoid Nevus
HISTORY 23-year-old woman presents with lifelong history of left cheek mole changing recently. Biopsy in 8/2017 showed compound nevus with severe atypia with spitzoid features. Excision was performed on 2-9-18. The patient a history of atypical mole of the left back removed in 2017. DISCUSSION Spitz nevi are are spindle /…
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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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Is there a Role for Sentinel Lymph Node Biopsy in Cutaneous Squamous Cell Carcinoma?
Sentinel lymph nodes are defined as the first lymph nodes that receive metastases from a primary tumor. The concept of a first echelon node was first described by Seaman and Powers and later given the name “sentinel node” by Gould in 1960. Cabanas established the basis of modern sentinel lymph node theory by advocating that…
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PDT Across the Atlantic and Medical Economics
Does medical economics bias the community standards for treatment of skin cancers? If the answer is yes, then photodynamic therapy serves as an illustrative example of this bias. Private practice dermatology in the US and National Health Service of UK are practice settings with significantly different economics and also different treatment goals. The one’s is…
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