Flashcards on Malignant Melanoma: Diagnosis, Staging, and Treatment

Malignant Melanoma: Diagnosis, Staging, Treatment for Students

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What biopsy type is recommended when a melanoma lesion is small to allow reliable diagnosis and measurement of depth of invasion?

Excisional biopsy with a 1–2 mm margin of normal-appearing skin.

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Melanoma surgical techniques

71 cards

Card 1

Question: What biopsy type is recommended when a melanoma lesion is small to allow reliable diagnosis and measurement of depth of invasion?

Answer: Excisional biopsy with a 1–2 mm margin of normal-appearing skin.

Card 2

Question: When is incisional (including punch) biopsy considered an acceptable alternative for melanoma diagnosis?

Answer: When the lesion is large or complete removal is impractical; incisional or punch biopsy can be used though it may underestimate depth of invasion.

Card 3

Question: Why is shave biopsy generally not preferred for suspected melanoma?

Answer: Because it may not provide adequate depth assessment; it is acceptable only when suspicion is low and the lesion is broad (e.g., some lentigo maligna/

Card 4

Question: What important pathological details must be reported from a melanoma biopsy specimen that influence subsequent surgical management?

Answer: Breslow thickness (mm), histologic ulceration, mitotic rate per mm², peripheral and deep margin status, and Clark level (for lesions ≤1 mm).

Card 5

Question: Name additional histopathologic features of potential significance that should be noted in melanoma biopsy reports.

Answer: Microscopic satellitosis, regression, tumor-infiltrating lymphocytes, neurotropism, and histologic subtype.

Card 6

Question: What is the primary purpose of wide local excision (WLE) in melanoma treatment?

Answer: To decrease the incidence of local recurrence.

Card 7

Question: What range of local recurrence rates for melanoma after treatment is reported in the literature?

Answer: Approximately 3% to 20%.

Card 8

Question: Which primary tumor locations have been associated with the highest risk of local recurrence after melanoma treatment?

Answer: The hands and feet (reported recurrence rate ~11–12%).

Card 9

Question: How do local recurrence rates compare for melanomas on the face, scalp, and ear versus hands and feet?

Answer: Face, scalp, and ear have lower recurrence rates (~5–6%) compared with hands and feet (~11–12%).

Card 10

Question: What concern exists about partial (incisional/punch) biopsy regarding later management steps like sentinel node biopsy?

Answer: Partial biopsy can underestimate depth of invasion, and the final excision may reveal greater depth; some patients might have been eligible for sentin