Mount Sinai Medical Center, Division of Dermatopathology, New York, USA.
Skin Institute, Auckland, New Zealand.
Eur J Surg Oncol. 2021 May;47(5):1140-1144. doi: 10.1016/j.ejso.2020.09.018. Epub 2020 Sep 22.
Achieving negative margins for melanoma in situ, lentigo maligna type can be challenging, particularly on cosmetically sensitive areas.
To assess the utility of intraoperative frozen section margin assessment using a teledermatopathology system in the treatment of head and neck lentigo maligna.
Over a 6 year period, 96 patients with lentigo maligna had surgical excisions. The margins were assessed intraoperatively with frozen sections prepared in the manner used in Mohs surgery. The surgeon guided the frozen section slides around the margin while a dermatopathologist assessed the margin remotely.
In 2/96 (2.1%) cases, the safety margin was positive (frozen sections were false negative). In 1 further case (1%) there was a recurrence of the melanoma 13 months following the excision.
The described method is effective in treating melanoma in situ, lentigo maligna type with clearance rates similar to previous studies for Mohs surgery.
对于原位黑素瘤中的恶性雀斑样痣型，实现阴性切缘可能具有挑战性，特别是在美容敏感区域。
评估远程皮肤病学系统在头颈部恶性雀斑样痣治疗中应用术中冷冻切片切缘评估的效用。
在 6 年期间，96 例恶性雀斑样痣患者接受了手术切除。术中采用 Mohs 手术中使用的方法制备冷冻切片，对切缘进行冰冻切片评估。外科医生在冷冻切片的引导下围绕切缘进行操作，同时皮肤病学家远程评估切缘。
在 96 例（2.1%）患者中，安全切缘阳性（冷冻切片为假阴性）。在另外 1 例（1%）患者中，在切除后 13 个月发生了黑色素瘤复发。
所描述的方法对于治疗原位黑素瘤、恶性雀斑样痣型是有效的，其清除率与 Mohs 手术的先前研究相似。
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