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Frozen section diagnosis of suspected malignant melanoma of the skin
Author(s) -
Little J. H.,
Davis N. C.
Publication year - 1974
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197410)34:4<1163::aid-cncr2820340428>3.0.co;2-c
Subject(s) - medicine , frozen section procedure , melanoma , nevus , basal cell carcinoma , dermatology , basal cell , pathology , radiology , cancer research
From 316 patients admitted to hospital, 329 pigmented skin lesions suspected of malignant melanoma were diagnosed by urgent frozen sections prepared in the cryostat. There were three groups: about one‐half were malignant melanomas, and about one‐quarter each were nevi and nonmelanocytic tumors, predominantly pigmented basal cell carcinomas and basal cell papillomas. Histologic error occurred in 4 cases (1.2%), and in 2 cases of combined nevi resulted in unnecessary surgery. The recognition of combined nevi is important in avoiding error; histologic guides are mentioned. The error rate is acceptable when compared with published rates of frozen section diagnoses on a wider range of tissues. The diagnosis was withheld in 19 lesions (5.8%); the causes were superficial level of the tumor, heavy lymphocytic infiltration, partial tumor regression, and unusual cell shape and arrangement in the melanomas. In the three groups the majority of lesions was less than 15 mm maximum diameter, and had no measurable height. Nearly 40% of the melanomas were Level I and II. Most of the nevi were compound, but an important group were combined nevi. Surgical excision was apparently excessive in 16 (5%) lesions. It is concluded that frozen section diagnosis of malignant melanoma in experienced hands is reliable and is of considerable value to the surgeon.