Flashcards on Malignant Melanoma: Diagnosis, Staging, and Treatment
Malignant Melanoma: Diagnosis, Staging, Treatment for Students
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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