Case discussion: How would you treat this patient? [26 October]
This week we feature a case discussion from Dr Terry Harvey, whose patient came in for a skin check:
- Adult male
- No history
Please review the clinical and dermoscopic images below. What is your assessment and what would you do next?
Here is the pathology result. What next?
7×5 right back flat pigmented lesion with brown reticular lines inferiorly, superiorly amelanotic with linear vessels eccentrically excision.
1. Right back: The specimen consists of a skin ellipse measuring 19 x 10 x 4 mm. On the skin surface is a pigmented macule measuring 5 x 4 mm. A marking nick is present which is placed at 12 o’clock. The 12 o’clock margin is scored and sections are taken as per the diagram. 3 TS submitted in 1A.
1. SYNOPTIC REPORT FOR IN-SITU MELANOMA
Site: Right back.
Type: Superficial spreading.
Associated benign melanocytic lesion: None identified.
Nearest peripheral margin: 2.5mm.
TNM stage (8th Edition): pTis.
Cancer Council Australia recommendation: 5mm clearance.
1. RIGHT BACK, EXCISION: IN SITU (LEVEL 1) MELANOMA, CLOSEST MARGIN 2.5MM.
We encourage you to participate in the case discussions and submit your own clinical images and questions, so we can all learn together.