Source
Department of Dermatology, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
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.