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To the Editor.—
The question by Solomon Garb, MD, of Denver is answered by an anesthesiologist, John Adriani, MD (238:1851, 1977), and leaves one to think that the injection of a local anesthetic for excision or incisional biopsy of a malignant lesion could theoretically cause the spread of malignant melanoma cells. There have been several good studies to indicate that incisional biopsies do not in any way change the overall prognosis of patients with malignant melanomas.To infer that general anesthetic or regional block anesthetic is the correct procedure to use for biopsy of malignant lesions would certainly tend to decrease the number of early biopsies being done, and this more than anything else will tend to prevent the early diagnosis of stage I and stage II malignant melanomas when they are in a most curative stage.
Cranmer LG. Biopsy of Malignant Melanoma. JAMA. 1978;239(10):928. doi:10.1001/jama.1978.03280370024005