Control of excisional margins by conventional histopathological techniques in the treatment of skin tumours. An alternative to Mohs' technique

Abstract

For histological control of excisional margins, routinely fixed tumour specimens or, under certain conditions, specimens fixed immediately in warm formalin are processed in the histology laboratory. Strips are then cut from the undersurface, edge, and cross-section of the remainder of the specimen and processed further by routine paraffin techniques until H&E-stained sections of the entire periphery and mid-section are available. We suggest that the method is simple, easy to apply, and suitable for the assessment of excisional margins of a variety of skin tumours. Extremely low recurrence rates over a relatively long follow-up period substantiate the effectiveness of the method.

A phase III, randomized, open label study to evaluate the safety and efficacy of imiquimod 5% cream applied thrice weekly for 8 and 12 weeks in the treatment of low-risk nodular basal cell carcinoma

“…At 8 weeks after treatment, an excisional biopsy of the primary tumor location and size (photodocumented and traced before start of therapy) with a microscopic evaluation of the peripheral and base margins was performed (3D-Histology). 10 For this purpose, the tumor was excised with a clinical safety margin of 3 mm using vertical incision lines. From the specimen (ex vivo), narrow lateral strips were cut into 4 pieces and placed in routine cassettes for permanent fixation of the lateral cut surgical margin.…”

Dermatofibrosarcoma protuberans: A clinicopathological, immunohistochemical, genetic ( COL1A1-PDGFB ), and therapeutic study of low-grade versus high-grade (fibrosarcomatous) tumors

“…24 The diagnosis of DFSP was histopathologically confirmed with an incisional biopsy before surgery. The tumors were debulked by excision.…”

Current treatment options in dermatofibrosarcoma protuberans

“…In contrast to WLE, which uses representative vertical sectioning, this technique requires continuing sequential horizontal sectioning (5-7 m) during the resection with immediate microscopic examination of the resected tissue by frozen material, until a clear margin is obtained (Mohs 1980;Ratner et al 1997;Chang et al 2004;Snow et al 2004). ModiWed MMS, established by Breuninger and Schaumburg-Lever (1988), uses paraYn-embedded sections. The intention is to detect the microscopic extensions of the tumor and to enable the surgeon to remove them with a greater accuracy.…”