Treatment of Cutaneous Melanoma of the Face by Mohs Micrographic Surgery

Abstract

Mohs micrographic surgery appears to be an effective treatment for facial melanomas. Our study showed complete correlation between frozen section tissue margins and permanent section controls.

Comparison of Outcomes for Malignant Melanoma of the Face Treated Using Mohs Micrographic Surgery and Wide Local Excision

“…The accuracy of frozen sections with MMS and permanent sections used for in situ and invasive melanoma has been found to be variable, with some reports showing excellent correlation, with a sensitivity of 100% and specificity of 90%, whereas others have shown significant discordance, with a sensitivity of 59% and specificity of 81% . At our institution, our technique has been shown to have complete correlation between frozen section tissue margins and permanent section controls …”

Treatment options in melanoma in situ: topical and radiation therapy, excision and Mohs surgery

“…In another study, Bienert et al. treated 97 patients with MIS or invasive melanoma on the face with FS Mohs by taking 5 mm margins and adding 2 mm margins until clear 64 . No recurrences were reported with an average of 33 months follow up.…”

“…No recurrences were reported with an average of 33 months follow up. The 117 margins that were deemed clear by FS were also evaluated by PS histology, and all were negative 64 …”

The Operative Management of Melanoma: Where Does Mohs Surgery Fit In?

“…The follow-up periods in six studies were from 22 to 58 months, and the number of cases ranged from 45 to 331. The largest study of 331 cases with a follow-up period of 58 months revealed a recurrence rate of 0.3% 9,10,12,17,[22][23][24] (Table 1). Only one study has demonstrated surgical excision to be superior to Mohs. This was a study of staged excisions with standard ''bread loaf'' cuts on 41 cases versus MMS on 18 cases of LM and LMM.…”