Emergent Diagnosis of Malignant Melanoma through Frozen Section

Are En Face Frozen Sections Accurate for Diagnosing Margin Status in Melanocytic Lesions?

“…Therefore, it may be more difficult to evaluate morphologic detail in frozen sections. Mainly for that reason, although several authors have advocated the use of frozen sections for the diagnosis of pigmented lesions, including lentigo maligna, [2][3][4] other authors have discouraged that method. 5,6 In addition to the technical problems associated with freezing, the evaluation of frozen sections to determine surgical margin status in pigmented lesions of the head and neck is complicated because of the presence of scattered atypical melanocytes, secondary to actinic damage.…”

“…Dermatology and 15 Biostatistics, the University of Texas M.D. Anderson Cancer Center, Houston; 2,10 University of Seattle, Seattle, WA; 3 George Washington University Medical Center, Washington, DC; 4 National Institutes of Health, Bethesda, MD; 5,9 University of Pennsylvania, Philadelphia; 6 University of Toronto, Toronto, Canada; 7 Northwestern University, Chicago, IL; 8 University of South Alabama, Mobile; 11 Rabkin Dermatopathology, Pittsburgh, PA; 12 Baylor College of Medicine, Houston; 13 Duke University Medical Center, Durham, NC; 14 University of Calgary, Calgary, Canada; 16 University of Chicago, Chicago, IL; and the [1][2][3][4][5][6][7][8][9][10][11][12][13][14]16…”

The universal detection of antigens from one skin biopsy specimen

“…There is also lack of consensus with regard to the ability to accurately determine Breslow tumor thickness of melanomas on frozen sections 7,47,49 . As a result of these problems, pathological interpretation of the frozen specimens is limited and has to be performed by an experienced pathologist 7,8,50,51 . Another shortcoming is the inconvenience of working with frozen tissues.…”

“…Despite these limitations, frozen sections are sometimes preferred over paraffin‐embedded sections, mainly because the processing is faster 8,9,50–52 . In certain cases, you would like to determine the appropriate surgical technique, and if applicable resection margins, during surgery.…”