Staged excision for lentigo maligna and lentigo maligna melanoma: A retrospective analysis of 117 cases - 24/04/13
Correspondence to: Kishwer S. Nehal, MD, Dermatology Service, Memorial Sloan-Kettering Cancer Center, 160 E 53 St, 2nd Floor, New York, NY 10022.Abstract |
Background |
Complete surgical excision for lentigo maligna (LM) and LM melanoma (LMM) in the head and neck region may be challenging because of potential significant subclinical extension.
Objective |
We sought to review clinical and histologic features of LM and LMM and determine surgical margin necessary for complete excision.
Methods |
We conducted a retrospective study of 117 LM and LMM cases treated with a staged margin-controlled excision technique with rush paraffin-embedded sections.
Results |
The mean total surgical margin required for excision of LM was 7.1 mm and was 10.3 mm for LMM. Of the tumors diagnosed as LM on initial biopsy specimen, 16% were found to have unsuspected invasion. Total surgical margin was associated with initial clinical lesion diameter.
Limitations |
Retrospective and single-institution experience are limitations.
Conclusion |
This study corroborates that the standard excision margins for LM and LMM are often inadequate and occult invasive melanoma occurs in LM. An excision technique with permanent sections using a team of dermatopathology and surgery that carefully examines the central tumor and the surgical margins is reliable for the treatment of LM and LMM.
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 58 - N° 1
P. 142-148 - janvier 2008 Retour au numéro
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