SUCCESSFUL TREATMENT OF LENTIGO-MALIGNA AND LENTIGO-MALIGNA MELANOMA WITH MOBS MICROGRAPHIC SURGERY AIDED BY RUSH PERMANENT SECTIONS

Background. Lentigo maligna (LM) is a pigmented neoplasm on sun-expose d skin of elderly patients. LM slowly increases in size and may become lentigo maligna melanoma (LMM), a potentially fatal malignancy. Compl ete excision is the treatment of choice. Mohs' micrographic surgery (M MS) with frozen and permanent sections may be used for complete eradic ation of the lesion, while sparing as much normal tissue as possible. The authors studied the efficacy of MMS for the treatment of LM and LM M. Methods. Between 1985 and 1999, 45 patients with LM (26) and LMM (1 9) were treated with MMS. The authors' technique was to use examinatio n of frozen sections and rush permanent sections (prepared and read wi thin 24 hours). Positive frozen sections warranted further excision. F or negative or equivocal frozen sections, surgery was interrupted unti l the examination of permanent sections was performed. Results. All 45 patients were free of local disease and evidence of metastases at an average of 29.2 months (range, 4-81 months) after therapy. Conclusions . MMS aided by rush permanent sections yielded a prolonged disease fre e survival for all 45 patients with LM or LMM. Because the MMS techniq ue minimizes the removal of normal tissue, and the local cure rate in this study was superior to that reported for conventional surgery, the authors recommend this technique for the treatment of LM and LMM.