The inadequacy of punch-excised melanocytic lesions: Sampling through the block for the determination of “margins” - 08/08/11
Reprint requests: Arlene S. Rosenberg, MD, MetroHealth Medical Center, Department of Dermatology, Case Western Reserve University School of Medicine, H567, 2500 MetroHealth Dr, Cleveland, OH 44109.Abstract |
Background |
Dermatopathologists often are asked by clinicians to report margins on punch excisions of melanocytic lesions.
Objective |
We sought to determine the adequacy of surgical margins on melanocytic lesions submitted with intention of complete excision using punch removal technique.
Methods |
We conducted prospective analysis of surgical margins on 266 consecutive patients who underwent attempted complete removal of 405 melanocytic nevi submitted as punch and fusiform excisions.
Results |
Of 206 nonbisected punch excisions, 127 (62%) had final positive margins. Of 159 bisected punch excisions, 76 (48%) had final positive margins. Of 40 elliptical excisions, two (5%) had final positive margins.
Limitations |
Information on the perilesional rim of nonpigmented skin included in the excision was not available.
Conclusions |
Of punch excisions, 56% had positive margins. Importantly, 30% of these punch excised specimens were negative on initial levels but had positive margins after extensive sectioning, affirming that fusiform excisions are the preferred method to evaluate margins in melanocytic lesions.
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| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Oral abstract presentation at the American Society of Dermatopathology 42nd Annual Meeting, Seattle, WA, October 23, 2005. |
Vol 60 - N° 6
P. 990-993 - juin 2009 Retour au numéro
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