Basal cell carcinoma surgery: Difference between revisions
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===Mohs Micrographic Surgery=== | ===Mohs Micrographic Surgery=== | ||
Mohs surgery involves removal of the tumor and a thin rim of normal-appearing skin<ref name="pmid15270883">{{cite journal| author=Smeets NW, Kuijpers DI, Nelemans P, Ostertag JU, Verhaegh ME, Krekels GA et al.| title=Mohs' micrographic surgery for treatment of basal cell carcinoma of the face--results of a retrospective study and review of the literature. | journal=Br J Dermatol | year= 2004 | volume= 151 | issue= 1 | pages= 141-7 | pmid=15270883 | doi=10.1111/j.1365-2133.2004.06047.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15270883 }} </ref>. Mohs micrographic surgery is indicated for the following: | Mohs surgery involves removal of the tumor and a thin rim of normal-appearing skin<ref name="pmid15270883">{{cite journal| author=Smeets NW, Kuijpers DI, Nelemans P, Ostertag JU, Verhaegh ME, Krekels GA et al.| title=Mohs' micrographic surgery for treatment of basal cell carcinoma of the face--results of a retrospective study and review of the literature. | journal=Br J Dermatol | year= 2004 | volume= 151 | issue= 1 | pages= 141-7 | pmid=15270883 | doi=10.1111/j.1365-2133.2004.06047.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15270883 }} </ref>. | ||
Mohs micrographic surgery is indicated for the following: | |||
*Tumors with poorly defined clinical borders | *Tumors with poorly defined clinical borders | ||
*Tumors with diameters > 1 cm located anywhere on the face | *Tumors with diameters > 1 cm located anywhere on the face | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D.
Overview
Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery.
Basal Cell Carcinoma Surgery
Types of surgery for basal cell carcinoma involve electrodesiccation and curettage, surgical excision, mohs micrographic surgery, and cryosurgery.
Electrodesiccation and Curettage
A curette is used to remove the tumor away from adjacent normal skin. Curetting is often followed by electrodesiccation, and the entire process may be repeated 1-2 more times. Electrodesiccation and curettage is a brief procedure and is effective in treating primary nodular and superficial basal cell carcinoma. The disadvantage of this procedure is it leaves a white, atrophic scar[1].
Surgical Excision
Surgical excision is performed to remove and examine the specimen under a microscope. The larger mount of skin that is removed, the higher the cure rate. Normally, 3-4 mm margins of normal skin are removed. Although surgical excision is more time-consuming and costly compared to curettage, it produces cure rates as high as 95%[2].
Mohs Micrographic Surgery
Mohs surgery involves removal of the tumor and a thin rim of normal-appearing skin[3].
Mohs micrographic surgery is indicated for the following:
- Tumors with poorly defined clinical borders
- Tumors with diameters > 1 cm located anywhere on the face
- Tumors with diameters > 2 cm located in areas other than the face
- Tumors with infiltrative or morpheaform/sclerotic histopathologic patterns
- Tumors arising in regions where a good cosmetic outcome is important
Cryosurgery
Cryosurgery may be considered for small, clinically well-defined primary tumors. This procedure is especially useful for patients who are debilitated with medical conditions. Liquid nitrogen is applied to the tumor, the treatment stops when the temperature reaches -60°C[4].
References
- ↑ Silverman MK, Kopf AW, Grin CM, Bart RS, Levenstein MJ (1991). "Recurrence rates of treated basal cell carcinomas. Part 2: Curettage-electrodesiccation". J Dermatol Surg Oncol. 17 (9): 720–6. PMID 1820764.
- ↑ Grabski WJ, Salasche SJ (1998). "Positive surgical excision margins of a basal cell carcinoma". Dermatol Surg. 24 (8): 921–4. PMID 9723063.
- ↑ Smeets NW, Kuijpers DI, Nelemans P, Ostertag JU, Verhaegh ME, Krekels GA; et al. (2004). "Mohs' micrographic surgery for treatment of basal cell carcinoma of the face--results of a retrospective study and review of the literature". Br J Dermatol. 151 (1): 141–7. doi:10.1111/j.1365-2133.2004.06047.x. PMID 15270883.
- ↑ Kaur S, Thami GP, Kanwar AJ (2003). "Basal cell carcinoma--treatment with cryosurgery". Indian J Dermatol Venereol Leprol. 69 (2): 188–90. PMID 17642878.