Modified purse string closure for excisional biopsy of pigmented lesions on extremities

e21041 Background: Malignant melanoma continues to have an increasing incidence worldwide without a decline in mortality, despite advances in treatment and early detection which have led to improved mortality outcomes for most malignancies. Early detection is particularly favorable for melanoma localized to the site of disease, which confers a five year survival rate of 98.4 %. Guidelines from the American Academy of Dermatology (AAD) give three acceptable options for the initial management of pigmented lesions suspicious for melanoma: elliptical excision, wide punch excision and a deep shave or saucerization. Methods: We performed a systematic review and meta-analysis to better define the evidence for differences between punch incisional and excisional biopsy with regard to clinically important outcomes in the evaluation of skin lesions suspicious for melanoma. These were melanoma specific mortality, all-cause mortality, Breslow tumor thickness, and melanoma recurrence. The comparison groups were punch incisional and excisional biopsy; there was insufficient data to include shave biopsies. Results: The result of pooling the studies that track melanoma specific mortality finds that there is a higher, but non-significant rate of death among those in the punch incisional group. The pooled risk ratio is 1.21, p = 0.153. The results of pooling the all-cause mortality studies also finds a higher, but non-significant, rate of death among the punch incisional group, RR = 1.03, p = 0.390. Pooling the two studies that examine Breslow thickness found that values in the punch incisional group are significantly lower, with a standardized mean difference of -0.17, p = 0.006. Finally, the pooled risk ratio for recurrence was not significant, RR = 1.161, p = 0.198. Conclusions: Until further data is available, there is no evidence to suggest a preferred diagnostic procedure in the initial evaluation of pigmented lesions suspected of cutaneous melanoma related to clinically important outcomes. To our knowledge, this is the first meta-analysis done on this important question regarding melanoma epidemiology and public health.

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Modified–purse-string closure: A lymphatic channel and tissue sparing technique for biopsy of suspicious pigmented lesions on extremities

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2018.02.061 ◽

2019 ◽

Vol 80 (2) ◽

pp. e33-e34

Author(s):

David M. Oberlin ◽

Dennis A. Porto ◽

Matteo C. LoPiccolo ◽

Laurie L. Kohen

Keyword(s):

Purse String ◽

Lymphatic Channel ◽

Pigmented Lesions ◽

Tissue Sparing

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Melanotic Oncocytic Metaplasia of the Nasopharynx in the Patient with Suspicious Hemoptysis: Case Report

Journal of Rhinology ◽

10.18787/jr.2020.00330 ◽

2020 ◽

Vol 27 (2) ◽

pp. 140-144

Author(s):

Taek Yoon Cheong ◽

Han Seong Kim ◽

Ick Soo Choi

Keyword(s):

English Literature ◽

Malignant Lesion ◽

Spontaneous Remission ◽

Excisional Biopsy ◽

Bleeding Risk ◽

Pigmented Lesions ◽

Left Posterior ◽

Slight Elevation ◽

Oncocytic Metaplasia

Melanotic oncocytic metaplasia (MOM) in the nasopharyngeal space is a very rare entity. Only 35 cases have been reported in the English literature, and most patients were East Asian males between 60 and 70 years of age. MOM presents as a brown or black lesion with slight elevation of the mucosa. These lesions are benign and defined as cellular enlargement with eosinophilic granular melanin-pigmented cytoplasm caused by mitochondrial accumulation. However, such presentation can lead physicians to misjudge MOM as a malignant lesion. Recently, we experienced a case of MOM of the nasopharynx. A 58-year-old woman was admitted to the internal medicine department with small-volume hemoptysis and referred to the ENT department for evaluation. She was a regular smoker without any medical history. Sinus endoscopy showed black pigmented lesions on both the torus tubaris and left posterior tonsillar pillar, with low bleeding risk. Excisional biopsy of the lesion was performed, and oncocytic metaplasia was confirmed pathologically. Hemoptysis showed spontaneous remission and no recurrence or other symptoms over 12 months of follow up. Melanotic oncocytic metaplasia in the nasopharynx should be clinically recognized to avoid misdiagnosis as a malignancy like melanoma.

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Excisional biopsy of a dysplastic nevus in a district polyclinic is a path to early detection of skin melanoma

Ambulatory surgery hospital-replacing technologies ◽

10.21518/1995-1477-2020-3-4-66-72 ◽

2021 ◽

pp. 66-72

Author(s):

N. G. Artemeva ◽

O. A. Romanova

Keyword(s):

Mortality Rate ◽

Early Diagnosis ◽

Cutaneous Melanoma ◽

Early Stage ◽

Excisional Biopsy ◽

Early Stage Disease ◽

Dysplastic Nevus ◽

Pigmented Lesions ◽

Grade 3 ◽

Surgery Department

Introduction. Russia has a high mortality rate of cutaneous melanoma – 2.5 per 100,000 population whereas the incidence rate is 7.7 per 100,000 population, i.e. one in every three patients dies. In the foreign countries (the USA, Australia), melanoma mortality rate is 10-15%. Such high rates are explained by the fact that patients with early-stage disease do not seek medical advice, as in early stages a tumour does not cause inconvenience to a patient and looks like an ordinary mole.The purpose of the study was to confirm the advisability of removing a progressive dysplastic nevus (grade 3 lentiginous melanocytic dysplasia) with a view to prevent and make early diagnosis of cutaneous melanoma.Materials and methods. The authors removed 180 pigmented lesions that were clinically diagnosed as a progressive dysplastic nevus in the Surgery Department of Central Polyclinic of Literary Fund from 2009 to March 2020. The patients were referred to the Surgery Department by physicians, dermatologists and other specialists of the polyclinic. Following an oncologist consultation, excisional biopsy of a nevus was performed under local anesthesia.Results. Histological examination revealed 29 (16%) dysplastic nevi with grade 3 LMD and 18 (10%) early-stage melanomas.Conclusions. If excisional biopsy of a dysplastic nevus becomes routine in Ambulatory Surgery practice, it will increase the early diagnosis of melanoma and significantly reduce mortality rates of this disease. For excisional biopsy, the authors recommend to excise at a distance of 0.5 to 1.0 cm from the lesion boundaries, since it is not possible to clinically distinguish a progressive dysplastic nevus from early melanoma.

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Intramucosal Nevus in the Oral Cavity

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1638 ◽

2015 ◽

Vol 16 (1) ◽

pp. 74-76 ◽

Cited By ~ 1

Author(s):

Daniel Antunes Freitas ◽

Paulo Rogério Bonan ◽

Arlen Almeida Sousa ◽

Mayane Moura Pereira ◽

Stephany Mendes Oliveira ◽

...

Keyword(s):

Oral Cavity ◽

Oral Mucosa ◽

Clinical Case ◽

Excisional Biopsy ◽

Pigmented Lesions ◽

Pigmented Lesion ◽

Mucous Membranes ◽

Uncommon Condition ◽

Dental Professionals

ABSTRACT Aim The aim of this study is to report a clinical case of oral nevus. Background Nevus is a congenital or acquired benign neoplasia that can be observed in the skin or mucous membranes. It is an uncommon condition in the oral mucosa. When it does occur, the preferred location is on the palate, followed by the cheek mucosa, lip and tongue. Case report In this case study, we relate the diagnosis and treatment of a 23-year-old female patient with an irregular, pigmented lesion of the oral mucosa that underwent excisional biopsy resulting in a diagnosis of intramucosal nevus. Conclusion Nevus can appear in the oral mucosa and should be removed. Clinical significance It is important for dental professionals to adequately categorize and treat pigmented lesions in the mouth. How to cite this article Freitas DA, Bonan PR, Sousa AA, Pereira MM, Oliveira SM, Jones KM. Intramucosal Nevus in the Oral Cavity. J Contemp Dent Pract 2015;16(1):74-76.

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