Maximum margin of excision is needed for:
Margins of excision: Malignant melanoma: Margins to be taken depends on the tumor thickness and depth of invasion* < 1mm thickness - 1 cm margin* 1-4 mm thickness - 2cm margin* > 4mm thickness - 2-3 cm margin BCC: If tumor is non-aggressive involving trunk or extremities -Wide Local Excision If tumor is aggressive involving vital areas, cosmetic areas and recurrent - MOH'Smicrographic surgery SCC: Small or non-invasive SCC - Wide Local excision MOH'S MICROGRAPHIC Surgery- Large tumors- Aggressive tumors- Tumors involving vital areas/ cosmetic areas- Recurrent tumorsMOH'S MICROGRAPHIC SURGERY- Serial excision of tumor in small increments- Coupled with immediate microscopic analysis to ensure tumor removal- To limit resection of aesthetically valuable tissues Dermatofibrosarcoma protuberans: WLE with 2-4 cm circumferential margin + removal of underlying fascia Has unpredictable radial extensions of tumor|Permeate through large distances from primarynodule|Increased risk of recurrence after simple excision|(2-4 cm) circumferential margin is resected toprevent recurrence
Malignant melanoma
BCC
SCC
Dermatofibrosarcoma protuberans
Oncology