Lentigo maligna. The use of rush permanent sections in therapy

Dhawan, Sunil; Wolf, Daniel J.; Rabinovitz, Harold; Poulos, Ernest

doi:10.1001/archderm.126.7.928

Cited by 59 publications

(59 citation statements)

References 15 publications

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“…In 1990, Dhawan et al 30 described a modified staged surgery for LM treatment. Later called "slow Mohs," their technique called for excising and mapping the tumor by Mohs technique with beveled edges, and then fixing the tissue in formaldehyde and sending it for "rush" permanent sections to be examined by a dermatopathologist.…”

Section: Mohsmentioning

confidence: 99%

Management of Lentigo Maligna and Lentigo Maligna Melanoma With Staged Excision

Bub¹,

Berg²,

Slee³

et al. 2004

Arch Dermatol

165

133

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Section: Mohsmentioning

confidence: 99%

Management of Lentigo Maligna and Lentigo Maligna Melanoma With Staged Excision

Bub¹,

Berg²,

Slee³

et al. 2004

Arch Dermatol

165

133

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“…Drawbacks to MMS include the difficulty of histological diagnosis of frozen sections. Modified versions of MMS have developed, using immunostaining [8,9] and rush permanent sections [2,5,[10][11][12] to deal with this difficulty. Successful MMS also requires specific training and experience.…”

Section: Introductionmentioning

confidence: 99%

The perimeter technique for lentigo maligna: an alternative to Mohs micrographic surgery

Mahoney¹,

Joseph²,

Temple³

2005

J. Surg. Oncol.

104

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Background: Lentigo maligna (LM) presents a challenge for complete surgical excision because of its extensive subclinical spread and predilection for the face. Objective: To report our experience using the staged perimeter technique as an alternative to Mohs micrographic surgery for treatment of LM. Methods: The perimeter procedure was performed on 11 patients with LM between March 2003 and June 2004. Data on patient and lesion characteristics, number of stages required to obtain clear margins, and follow-up was obtained by chart review. Results: A mean of 1.9 stages were required to achieve clear margins. A mean of 7 tissue specimens were sent to pathology per patient for evaluation. After a mean follow-up of 4.7 months, all patients were free of recurrence. Conclusions: The perimeter technique is a simple method of margin-controlled excision of LM. The main advantage is that all margins are examined with permanent sections. The main drawback is that multiple operative sessions are required to complete the procedure. This technique does not require specific Mohs training and is therefore applicable to non-Mohs surgeons.

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“…[18][19][20][21] Staged excision of melanoma is another alternative excision method that promises not only to retain tissue sparing but also to allow for paraffin-embedded tissue processing, thus avoiding any keratinocyte freeze artifact. [22][23][24][25][26][27][28] In addition, marginal evaluation is performed by a trained dermatopathologist, something that we consider to be extremely important for delineating lesional margins because melanocytic hyperplasia may be difficult to differentiate from melanocytic neoplasia (ie, MIS) even for a trained, experienced dermatologist. Staged excision, to date, has demonstrated low rates of persistence of 0% to 7% among all published data.…”

mentioning

confidence: 99%

Geometric Staged Excision for the Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

Abdelmalek

Loosemore²,

Hurt³

et al. 2012

Arch Dermatol

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To ascertain and clarify the effectiveness and advantages of the geometric staged excision technique for the removal of lentigo maligna (LM) and lentigo maligna melanoma (LMM).Design: This was a retrospective review of a patient database composed of 293 cases of LM and LMM.Setting: The Laser and Dermatologic Surgery Center in St Louis, Missouri, an academic-affiliated, private dermatologic surgery center.Patients: All patients with a diagnosis of LM and LMM treated by staged excision from 1999 to 2007. Main Outcome Measures:The overall rate of recrudescence, margins required for clearance, stages re-quired for clearance, and lesional characteristics were examined.Results: The rate of recrudescence after geometric staged excision was 1.7% (4/239), with a mean of 32.3 months of follow-up. The mean margin to clearance after excision was 6.6 mm for LM and 8.2 mm for LMM. A total of 11.7% of LMM was initially diagnosed as LM on biopsy, with the invasive component discovered during the excision.Conclusions: Geometric staged excision is an optimal method of removal of LM and LMM given its low rate of recrudescence and ability for complete examination of the peripheral and deep margins of the specimens.

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Lentigo maligna. The use of rush permanent sections in therapy

Cited by 59 publications

References 15 publications

Management of Lentigo Maligna and Lentigo Maligna Melanoma With Staged Excision

Management of Lentigo Maligna and Lentigo Maligna Melanoma With Staged Excision

The perimeter technique for lentigo maligna: an alternative to Mohs micrographic surgery

Geometric Staged Excision for the Treatment of Lentigo Maligna and Lentigo Maligna Melanoma

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