ABSTRACT
Resumo O lentigo maligno é um melanoma in situ, de crescimento radial e lento, que acomete áreas fotoexpostas principalmente em idosos. Quando acomete a pálpebra, devido à proximidade a um órgão nobre, a conduta é controversa, porém a cirurgia é o método mais usado, com margens que variam de acordo com a referência utilizada. Terapias conservadoras são descritas, como o imiquimode 5% e a radioterapia. O presente relato tem como objetivo demonstrar a escassez de estudos sobre a margem cirúrgica e citar opções de tratamentos não cirúrgicos para o lentigo maligno da face.
Abstract Lentigo maligna is a melanoma in situ, of slow radial growth, which affects sun-exposed areas, especially in the elderly. When it affects the eyelid, due to the proximity to a noble organ, the conduct is controversial, but surgery is the method most commonly used, with with margins varying according to the reference used. Conservative treatments are described, such as imiquimod 5% and radiotherapy. This report aims to demonstrate the lack of studies on the surgical margin, and to name nonsurgical treatment options for lentigo maligna of the face.
Subject(s)
Humans , Female , Aged , Hutchinson's Melanotic Freckle/surgery , Hutchinson's Melanotic Freckle/pathology , Eye Neoplasms/surgery , Eye Neoplasms/pathology , Eyelid Neoplasms/surgery , Eyelid Neoplasms/pathology , Ophthalmologic Surgical Procedures/methods , Biopsy , Orbit Evisceration , Dermoscopy , Margins of ExcisionABSTRACT
The surgical approach to lentigo maligna is a challenge to dermatologists, given the difficulty of clinical delimitation of borders. We report here a case of a 69-year-old female patient presenting with brownish macules on her face, since 10 years ago, with histopathological diagnosis of lentigo maligna. The surgical management employed was excision of visible borders with the contoured technique and immediate submission of these borders for histopathological analysis before complete excision of the tumor. This technique is a variant of staged excision, with lower rates of recurrence and acceptable aesthetic results.
Subject(s)
Humans , Female , Aged , Skin Neoplasms/surgery , Hutchinson's Melanotic Freckle/surgery , Dermatologic Surgical Procedures/methods , Skin Neoplasms/pathology , Facial Neoplasms/surgery , Facial Neoplasms/pathology , Reproducibility of Results , Treatment Outcome , Hutchinson's Melanotic Freckle/pathology , Medical IllustrationABSTRACT
El léntigo maligno es un melanoma in situ y representa la lesión precursora del léntigo maligno melanoma, la forma invasora de este tumor. El léntigo maligno tiene unas características especiales que lo diferencian de las otras variantes del melanoma in situ, tanto en su presentación clínica como en su apariencia histológica y en su comportamiento biológico. El conocimiento de cada uno de estos aspectos de la biología tumoral permite al médico tratante la elección de la mejor alternativa terapéutica en cada caso.
Subject(s)
Hutchinson's Melanotic Freckle , Hutchinson's Melanotic Freckle/surgery , Hutchinson's Melanotic Freckle/pathology , Hutchinson's Melanotic Freckle/therapy , Skin NeoplasmsABSTRACT
Se presenta un caso problema con melanoma en cara de más de 3 años de evolución en una paciente de sexo femenino, de 77 años, con antecedentes de exposición solar, rayos X y fentipo de alto riesgo. Se propone y realiza tratamiento quirúrgico adecuado, racionalizando medios y resultado estético.
It is propouse a simple and clasic method to solve a Hutchinson melanoma on the face. Any furthers are disscused and how to do.