Recurrence rate of lentigo maligna after micrographically controlled staged surgical excision

2016 ◽  
Vol 174 (3) ◽  
pp. 588-593 ◽  
Author(s):  
K. de Vries ◽  
K. Greveling ◽  
L.M. Prens ◽  
K. Munte ◽  
S. Koljenović ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Surgical Excision ◽  
Lentigo Maligna

scholarly journals Out Come of Wide Local Excision with and without Corticosteroid Therapy in Management of Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 107 (1_suppl) ◽  
pp. 13-13
Author(s):  
R Amira Maher ◽  
Ahmed Gamal Eldin Osman ◽  
K Fahmy ◽  
Shinamwi M ◽  
Osama Al Atarash
Keyword(s):  
Recurrence Rate ◽  
Corticosteroid Therapy ◽  
Surgical Excision ◽  
Cosmetic Outcome ◽  
Systemic Steroid ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Palpable Mass ◽  
Group A ◽  
Group B

Introduction: Idiopathic granulomatous mastitis is a rare benign breast disease. Initial reports from hospitals in Egypt from Departments of Pathology at Cancer Institutes of Cairo, Tanta and Mansoura Universities; indicate that the disease is not as rare as that in the developed countries. It often mimics breast carcinoma both clinically and radiologically. Histological examination is the gold standard for diagnosis. Management of Idiopathic granulomatous mastitis is still debatable. In our study, we aimed to evaluate the addition of corticosteroid therapy to surgical excision in management of idiopathic granulomatous mastitis. Patients and Methods: This is a comparative study was conducted at Ain-Shams University Hospital’s breast clinic on patients with idiopathic granulomatous mastitis from to August 2015 till September 2018. Thirty patients were divided into 2 groups. Group (A) includes patients who underwent surgical management only. Group (B) includes patients who received corticosteroid therapy according to the severity of the cases then surgical Excision was done for the residual lesion. Follow up of all cases up to 1-2 years was done to document the recurrence rate and compare the cosmetic outcome of both groups. Informed consent was obtained from all patients included in the study. Results: The mean age of the affected women was 38.80 and 33.13 in group (A) and group (B), respectively and it wasn’t statistically different (p value = 0.099). The most common presenting symptom was a palpable mass in the breast (66.7% and 93.3%) in group (A) and group (B) respectively. Recurrence rate was higher in group (A) (40%) with no recurrence documented in group (B) however 2 cases were omitted from the study due to steroid noncompliance and complications. Cosmetic outcome was excellent in 76.9% of group (B) and good in 53.3% of group (A). Conclusion: Systemic steroid therapy with surgical resection is the recommended as first-line treatment strategy for IGM as it shows less recurrence rate and surgical scarring. Increased awareness of IGM will increase their understanding and improve their management.

scholarly journals Idiopathic granulomatous mastitis: challenges of treatment in iranian women

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leyla Shojaee ◽  
Nasrin Rahmani ◽  
Siavash Moradi ◽  
Asieh Motamedi ◽  
Gholamali Godazandeh
Keyword(s):  
Recurrence Rate ◽  
Low Dose ◽  
Unknown Origin ◽  
Surgical Excision ◽  
Chronic Inflammatory Disease ◽  
High Dose ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Results Of Treatment ◽  
Information Treatment

Abstract Background and objective As a chronic inflammatory disease of an unknown origin, the treatment of granulomatous mastitis has always been controversial. According to some researchers, surgical treatment and certain medications, especially steroids, are more effective in treating the disease. This study aimed at evaluating the results of treatment in a group of patients with granulomatous mastitis. Materials and methods This longitudinal cohort study evaluated the treatment outcomes of 87 patients with pathology-confirmed granulomatous mastitis referred to the surgical clinic of Central Hospital in Sari, Iran. Demographic, clinical, and pathological information, treatment methods and results, and the recurrence rate were analyzed. Findings A total of 87 female patients with granulomatous mastitis aged 22–52 years with a mean age of 34 years were evaluated. All patients had palpable masses; the breast masses were painful in 48.3% of patients, and 55.2% of patients suffered from erythema and inflammation, and8% had fistulas and ulcers at the inflammation site. The patients were followed-up for an average duration of 26 months (8–48 months) after treatment and recovery. The overall recurrence rate was 24.1%, and the recurrence rate was 29.4% in patients underwent surgery, 34.8% in patients received high-dose prednisolone, and 17% in those received low-dose prednisolone together with drainage (p < 0.001). Conclusions According to the results, the low-dose prednisolone plus drainage was more effective with a lower recurrence rate than only surgical excision or high-dose prednisolone. In fact, the use of minimally invasive methods such as drainage plus low-dose steroids is a more effective method with fewer side effects than the other two methods.

Immunocryosurgery as monotherapy for lentigo maligna or combined with surgical excision for lentigo maligna melanoma

2018 ◽  
Vol 45 (5) ◽  
pp. 564-570 ◽  
Author(s):  
Clara Matas-Nadal ◽  
Xavier Sòria ◽  
María R. García-de-la-Fuente ◽  
Valentín Huerva ◽  
Eugenia Ortega ◽  
...  
Keyword(s):  
Surgical Excision ◽  
Lentigo Maligna ◽  
Lentigo Maligna Melanoma

Malignant melanoma of the ear

1993 ◽  
Vol 107 (9) ◽  
pp. 798-802 ◽  
Author(s):  
Åke Davidsson ◽  
Henrik B. Hellquist ◽  
Kenneth Villman ◽  
Gunnar Westman
Keyword(s):  
Malignant Melanoma ◽  
Prognostic Value ◽  
Surgical Excision ◽  
Malignant Tumour ◽  
External Ear ◽  
Prognostic Parameters ◽  
Lentigo Maligna ◽  
Superficial Spreading ◽  
Prognosis Estimation

AbstractThis paper reports on 16 cases of primary malignant melanoma of the external ear and the patients were followed up for two to 116 months. Fourteen patients had surgical excision with wide margins as initial treatment, whilst two had an amputation performed. Eleven patients had no recurrences, two died of other diseases, and four died of malignant melanoma. The five patients who developed recurrences received further surgery and two also radiotherapy.Seven of the cases were histologically of the nodular type, six were superficial spreading, two were in situ melanoma, and one was a lentigo maligna. The thickness ranged from 0.15 to 11.5 mm. Classification according to Clark et al. (1969) revaled that as many as nine cases were Clark level IV or more. Immunostaining with PCNA yielded strong positivity in all cases, however, statistical analysis did not reveal any differences that could be correlated to the prognosis. Estimation of the vascularization at the base of the tumours by means of immunostaining with CD31 did not reveal any significant differences either.We concluded that in our material the thickness of the tumour is of greater prognostic value than the estimation of proliferation by PCNA and vascularization by CD31. The value of PCNA and CD31 as possible prognostic parameters needs to be evaluated in a larger series. It is emphasized that malignant melanoma of the external ear is a highly malignant tumour, and that four of our 16 patients died of their disease, three of them within a year after diagnosis. Malignant melanoma of the external ear is readily inspected and thereby an early diagnosis should be possible.

scholarly journals Evaluating the Diagnostic Accuracy of Reflectance Confocal Microscopy to Diagnose Skin Cancer: A Research Protocol (Preprint)

2017 ◽  
Author(s):  
Naomi D Herz ◽  
Anastasia Chalkidou ◽  
Fiona Reid ◽  
Stephen Keevil ◽  
Andrew Coleman ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Confocal Microscopy ◽  
Surgical Excision ◽  
Reflectance Confocal Microscopy ◽  
Lentigo Maligna ◽  
Recurrence Rates ◽  
Skin Cancer Screening ◽  
Lentigo Maligna Melanoma ◽  
Excision Margins ◽  
The Uk

UNSTRUCTURED Skin cancer is the most common type of cancer in the UK, with over 100,000 cases diagnosed each year. Melanoma is a type of skin cancer that can develop from a mole. However, moles that are suspicious histologically are often difficult to diagnose clinically by eye, even for experts working in specialist skin cancer screening clinics. In the UK, 350,000 patients per year are referred to hospital clinics with suspicious moles, and approximately half undergo a biopsy to identify the 5-10% who require further treatment. If cancer cannot be ruled out clinically and on the basis of biopsy results, the lesion is surgically removed. One type of pre-cancerous mole, called lentigo maligna, is particularly challenging to treat. It develops insidiously, can become large, and is difficult to assess when it transforms into a lentigo maligna melanoma. It is also difficult to identify the margins by eye or with the aid of a dermatoscope. This results in high excision rates. Excision is often incomplete despite large areas of tissue removal (5 mm around tumour’s visible margin), and there are high recurrence rates even when the lesion is considered successfully removed. Reflectance confocal microscopy is an imaging technique that can supplement dermoscopy in identifying if a clinically suspicious mole is malignant and can better assess lentigo maligna margins. It allows clinicians to see the skin lesion in greater detail than dermoscopy and therefore better guide more accurate diagnoses. This prospective study will examine patients with suspicious moles and lentigo maligna to determine whether confocal microscopy can both reduce the number of unnecessary biopsies of moles and more accurately guide the surgical excision margins of lentigo maligna.

scholarly journals Comparing preoperative mapping with reflectance confocal microscopy to surgical markings in lentigo maligna excision of the face: a pilot study

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Lipi Shukla ◽  
Louise Photiou ◽  
Alan Pham ◽  
Catriona McLean ◽  
Raquel Ruiz ◽  
...  
Keyword(s):  
Pilot Study ◽  
Confocal Microscopy ◽  
Surgical Margin ◽  
Surgical Excision ◽  
Reflectance Confocal Microscopy ◽  
Histopathological Analysis ◽  
Lentigo Maligna ◽  
Complete Excision ◽  
Preoperative Mapping

Background: Lentigo maligna (LM) characteristically has an ill-defined margin and may require multiple excisions to achieve complete excision with 5mm margins. In vivo reflectance confocal microscopy (RCM) is a non-invasive tool recognised as useful in the management of LM. The authors aimed to determine whether the use of RCM prior to surgical excision reliably increased the rate of complete excision when compared with standard surgical excision. Methods: This prospective pilot study included patients with biopsy-proven LM of head and neck region who sought consultation for surgical management from May 2017 to May 2019 at the Victorian Melanoma Service, Melbourne. Patients were randomised to two groups based on the availability of RCM — Group 1, RCM-guided surgical excision, and Group 2, standard surgical excision. Outcomes were measured based on clinical markings and histopathological margins achieved and reported as RCM or surgical margin excess or deficit. Ethics approval for the study was obtained from the Research Governance Unit of The Alfred Hospital, Melbourne. Results: Results demonstrated that RCM marking of lesion margins was in excess in 69 percent of cases, in deficit in 22 per cent and accurate in nine per cent after histopathological analysis of the specimens. In comparison, lesions that were surgically marked were removed with margins in excess in 43 per cent of cases, in deficit in 11 per cent and accurate in 46 per cent. Conclusion: This pilot study demonstrates that RCM did not increase the accuracy of LM surgical excision in comparison with standard surgically marked excisions.

scholarly journals Use of Triamcinolone in keloid

2021 ◽  
Author(s):  
Shwetha B. ◽  
Sathyaki D. C.
Keyword(s):  
Recurrence Rate ◽  
Tertiary Care ◽  
Surgical Excision ◽  
Weekly Interval ◽  
Treatment Modalities ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Triamcinolone Injection

<p class="abstract"><strong>Background:</strong> Keloids are well known for recurrence. There is no standardized regimen for the treatment of keloids. Many different treatment modalities such as surgical excision, intralesional corticosteroids, radiotherapy, and pressure earrings have been used for keloids. Surgical excision alone may result in recurrence rate of 40-100%. Many different modalities of treatment have been tried to prevent recurrence. Aims and objectives of the study was to evaluate the efficacy of Triamcinolone in preventing recurrence of Keloid.</p><p class="abstract"><strong>Methods: </strong>40 patients who underwent excision of keloid at a tertiary care centre. Surgery alone was performed in 20 patients and surgery with post operative intra lesional Triamcinolone injection was given weekly interval for 6 weeks in another 20 patients. Patients were followed up for the period of 2 years</p><p class="abstract"><strong>Results: </strong>Recurrence was found in 5 patients who underwent excision alone and there was no recurrence among patients who received post operative intra lesional triamcinolone.</p><p class="abstract"><strong>Conclusions: </strong>Multi modality treatment is better to prevent recurrence of Keloid.</p>

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