Source: British Journal of Oral and Maxillofacial Surgery; Dec 2016; vol. 54 (no. 10)
Publication Date: Dec 2016
Publication Type(s): Journal: Conference Abstract
Abstract: Introduction:Lentigo maligna is a melanoma-in-situ which typically develops on chronically sun damaged skin in older patients. The reported risk of progression to malignant melanoma is between 5% and 20%. Complete surgical excision with a 5 mm to 10 mm margin is the standard treatment for lentigo maligna (Hou et al., 2015).Aims:We aim to assess the adequacy of a predetermined 5 mm clinical excision margin for lentigo maligna with respect to complete excision and histological margin.Methods: Patients who have undergone excision of facial lentigo maligna with a predetermined 5 mm margin within our unit since 2011 are included in this ongoing audit. The data collection sheet documented patient demographics, surgical margin, and completeness of excision, histological margin and skin MDT recommendation.Results: Of the first 21 patients who have undergone excision of lentigo maligna, 20 were completely excised. The closest mean histological margin was 2.74 mm. Skin MDT recommended that 2 patients with completely excised lentigo maligna undergo further excision because the closest histological margin was less than 2 mm.Discussion: In our unit, excision of lentigo maligna with a predetermined 5 mm surgical margin resulted in an excision rate of 95%. There is a lack of evidence correlating histological margin and recurrence rate however Akhtar et al reported a recurrence rate of 1.4% with a histological margin less than 2 mm (Akhtar et al., 2014).The face is a cosmetically sensitive area which is challenging to reconstruct and this small ongoing audit suggests that wider excision is not necessary to achieve a safe histological margin.