Boeta ÁL, Lacy NRM, Guevara SE

Language: Spanish
References: 23
Page: 136-143
PDF size: 278.30 Kb.

ABSTRACT

Background: Mohs micrographic surgery (mms) is indicated for the treatment of non melanoma skin cancer and cancer of mucous membranes with high cure rates. It has also been proved that mms is effective to completely excise melanomas in situ or invasive malignant melanomas (mm).
Objective: To report our experience in the treatment of mm with mms.
Material and Methods: We performed mms in nine patients with stage ia mm. One to four stages were taken with 2-3 mm margins each until reaching a tumour free level. Frozen and paraffin slides were obtained and then stained with hematoxylin and eosin. Patients were followed up monthly for a three–month period after surgery, later every six months and then once a year.
Results: Six patients had melanomas in situ and three patients Clark II invasive melanomas with Breslow levels varying from 0.2 to 0.8 mm. Six lesions were located on the face, one on the trunk and two on the ungueal unit. The lesions have been noted by the patients from one to 25 years before diagnosis. One to four stages were performed to completely excise the tumours with final margins of 3 to 9 mm. Second intention healing was allowed in three surgical defects, primary closure was performed in two patients, rotation flaps in three and a free graft in one patient. The patients have been followed up from six months to ten years without evidence of recurrence, local or distant metastases.
Conclusions: mms was effective in the treatment of all nine mm in our series without evidence of recurrence, local or distant metastases. This technique offered healthy tissue sparing and complete excision of the tumours with narrow margins. mms is a reliable and effective treatment for mm.

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