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Skin and soft tissue
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Historically, margins as high as 5 cm were used; recent guidelines suggest 2–4 cm (NCCN, National Comprehensive Cancer Network 2007 and 2014) along with complete circumferential peripheral and deep margin assessment (CCPDMA, of which Mohs surgery is an example) – taking the deep and lateral faces for complete frozen section examination to avoid the false-negative error inherent in ‘bread loafing’.
Basal Cell and Squamous Cell Carcinomas
Published in Dongyou Liu, Tumors and Cancers, 2017
For a small BCC in a young person, the treatment with the best cure rate is Mohs surgery (a technique to remove the cancer with the least amount of surrounding tissue) or complete circumferential peripheral and deep margin assessment (CCPDMA). For an elderly frail individual with a difficult-to-excise BCC and multiple complicating medical problems, radiotherapy (slightly lower cure rate) or no treatment is prescribed. For large, superficial BCC, topical chemotherapy (5-fluorouracil or imiquimod) might be indicated for good cosmetic outcome.
Morpheaform basal cell carcinoma of the nasal ala associated with multiple familial trichoepithelioma reconstructed by anterolateral thigh flap: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Masakatsu Hihara, Yuuki Kouchi, Tsugumi Takao, Maako Fujita, Natsuko Kakudo
Under general anesthesia, the skin incision line was set with a 10 mm excision margin, and extended resection of the ulcerative lesion was performed. This morpheaform BCC involved the mimic muscles, resulting in extended resection of the right nasal ala, including the greater alar cartilage and a partial anterior wall of the maxilla. This patient was clinically diagnosed with definite BCC at the time of presentation with concomitant ulcerative lesions. Therefore, no immunohistochemical staining was performed to differentiate trichoepithelioma from BCC. The nasal cavity and right maxillary sinus were exposed accordingly (Figure 1). Negative surgical margins were confirmed by a complete circumferential peripheral and deep margin assessment (CCPDMA).
Dermatofibrosarcoma protuberans: our 10-year experience on 80 patients
Published in Journal of Dermatological Treatment, 2020
Xiaobo Zhou, Di Sun, Yang Liu, Qilin Sun, Zhaoqi Yuan, Xusong Luo, Jun Yang, Jun Chen
The standard treatment of localized primary or recurrent DFSP recommended by the National Comprehensive Cancer Network is surgeries including Mohs micrographic surgery (MMS), Modified Mohs, complete circumferential peripheral and deep margin assessment (CCPDMA), and wide large excision (WLE) with at least 2 cm margin to fascia or muscle with clear pathological margins (8).