From the Departments of Otolaryngology (Drs Anderson, Baker, and Johnson),
Dermatology (Drs Lowe, Su, and Johnson), Pathology (Drs Lowe and Su), and
Surgery (Dr Johnson), University of Michigan Health System, Ann Arbor.
Melanoma with the lentigo maligna histological pattern often provides
a significant and difficult challenge to the head and neck surgeon. The lentigo
maligna subtype is the most common type of melanoma on the head and neck.
This potentially lethal form of cancer is associated with greater nonvisual
lesional extension that is often not clinically apparent. Failure to excise
the entire lesion results in a higher risk of local recurrence and a poorer
prognosis. The staged excision technique described herein results in histological
interpretation of 100% of the peripheral margins using formalin-fixed vertical
sections. Definitive local excision and soft tissue reconstruction are performed
in a subsequent stage, with an assurance that 100% of the peripheral margins
have been evaluated and interpreted as free of disease.
Anderson KW, Baker SR, Lowe L, Su L, Johnson TM. Treatment of Head and Neck Melanoma, Lentigo Maligna SubtypeA Practical Surgical Technique. Arch Facial Plast Surg. 2001;3(3):202-206. doi: