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Saucerization Biopsy

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21. Lentigo Maligna Melanoma (Treatment)

excision, saucerization, or punch biopsy, if the lesion is small enough. The specimen should include a portion of subcutaneous fat to ensure that accurate microstaging can be determined. Previous Next: Lymph Node Biopsy Sentinel lymph node biopsy is done to assess regional lymph node involvement and to decide on adjuvant therapy. This technique is indicated in all melanoma patients except those with stage 0 or stage 1A disease, that is, patients with a lesion thinner than 1 mm (see Staging (...) for development of melanoma. Previous Next: Diagnostic Considerations Distinguishing lentigo maligna from its invasive counterpart on a clinical basis continues to present diagnostic dilemmas, especially in patients who had previous therapeutic interventions such as cryotherapy. It is important to have a low threshold for biopsy of pigmented facial lesions. In a series of 85 excised lesions with a clinical diagnosis of lentigo maligna, more than 50% had invasive lentigo maligna melanoma. The following

2014 eMedicine.com

22. Preoperative Evaluation and Management (Follow-up)

, and extensive patient evaluation is unnecessary. Some of these simple procedures include limited cryosurgery, curettage, electrosurgery, punch and saucerization biopsies, and simple excisions. However, the need for patient evaluation is greater with more complex procedures, such as dermabrasion, hair transplantation, flaps, and grafts. Certain underlying physiologic and pathophysiologic problems demand attention and caution. Medications and dietary supplements are often numerous and need to be scrutinized (...) should be allowed to clear before elective procedures are undertaken. The process of hepatic stabilization may take several weeks past the risk period of delirium tremens following alcohol withdrawal. Hepatic function is best assessed by the clinical status, the return of transaminase levels to baseline, and/or a repeat biopsy of the liver. A natural decline in hepatic function occurs with age, which is important with respect to drug metabolism. The amide class of anesthetics (eg, lidocaine

2014 eMedicine.com

23. Oral Nevi (Follow-up)

):43-9. . Media Gallery This biopsy-proven intramucosal nevus on the gingiva is unusual because it is not raised and has an irregular outline. Intramucosal nevus on the lower lip. This brown papule measured 0.6 cm in diameter and was only slightly raised. Melanotic macules are invariably flat. Blue nevus on the gingiva. This 1-cm saucer-shaped tan macule on the gingiva has histologic features consistent with those of a blue nevus, which is the second most common type of oral nevus. This location (...) lip presentation in a black patient and a review of the subject. NDA J . 1994 Jan-Feb. 45(1):19-23. . Ide F, Mishima K, Yamada H, Saito I, Tanaka A, Kusama K. Neurotized nevi of the oral mucosa: an immunohistochemical and ultrastructural analysis of nevic corpuscles. J Oral Pathol Med . 2007 Sep. 36(8):505-10. . Cerrato F, Wallins JS, Webb ML, McCarty ER, Schmidt BA, Labow BI. Outcomes in pediatric atypical spitz tumors treated without sentinel lymph node biopsy. Pediatr Dermatol . 2012 Jul-Aug

2014 eMedicine.com

24. Lentigo Maligna Melanoma (Follow-up)

excision, saucerization, or punch biopsy, if the lesion is small enough. The specimen should include a portion of subcutaneous fat to ensure that accurate microstaging can be determined. Previous Next: Lymph Node Biopsy Sentinel lymph node biopsy is done to assess regional lymph node involvement and to decide on adjuvant therapy. This technique is indicated in all melanoma patients except those with stage 0 or stage 1A disease, that is, patients with a lesion thinner than 1 mm (see Staging (...) for development of melanoma. Previous Next: Diagnostic Considerations Distinguishing lentigo maligna from its invasive counterpart on a clinical basis continues to present diagnostic dilemmas, especially in patients who had previous therapeutic interventions such as cryotherapy. It is important to have a low threshold for biopsy of pigmented facial lesions. In a series of 85 excised lesions with a clinical diagnosis of lentigo maligna, more than 50% had invasive lentigo maligna melanoma. The following

2014 eMedicine.com

25. Lentigo Maligna Melanoma (Diagnosis)

excision, saucerization, or punch biopsy, if the lesion is small enough. The specimen should include a portion of subcutaneous fat to ensure that accurate microstaging can be determined. Previous Next: Lymph Node Biopsy Sentinel lymph node biopsy is done to assess regional lymph node involvement and to decide on adjuvant therapy. This technique is indicated in all melanoma patients except those with stage 0 or stage 1A disease, that is, patients with a lesion thinner than 1 mm (see Staging (...) for development of melanoma. Previous Next: Diagnostic Considerations Distinguishing lentigo maligna from its invasive counterpart on a clinical basis continues to present diagnostic dilemmas, especially in patients who had previous therapeutic interventions such as cryotherapy. It is important to have a low threshold for biopsy of pigmented facial lesions. In a series of 85 excised lesions with a clinical diagnosis of lentigo maligna, more than 50% had invasive lentigo maligna melanoma. The following

2014 eMedicine.com

26. Oral Nevi (Diagnosis)

. Blue nevus on the gingiva. This 1-cm saucer-shaped tan macule on the gingiva has histologic features consistent with those of a blue nevus, which is the second most common type of oral nevus. This location is atypical because most blue nevi occur on the palate. Junctional and compound nevi are uncommon, accounting for only 3-6% and 5.9-16.5%, respectively. [ , , ] Rarer types include Spitz nevi, cellular blue nevi, congenital nevi, combined nevi, balloon cell nevi, epithelioid blue nevi, plaque (...) underwent biopsies. [ ] Sex Oral mucosal nevi have a slight female predominance (1.5:1 female-to-male ratio), except for the blue nevi type, which occurs equally in both sexes. [ ] Age The average age at diagnosis is 35 years (range, 3-85 y). [ ] Male patients tend to be a few years older than female patients. Patients with junctional and compound nevi are relatively younger, with an average age at diagnosis of 22 and 24 years, respectively. Previous Next: Prognosis Reports mainly based on case reports

2014 eMedicine.com

27. Preoperative Evaluation and Management (Diagnosis)

, and extensive patient evaluation is unnecessary. Some of these simple procedures include limited cryosurgery, curettage, electrosurgery, punch and saucerization biopsies, and simple excisions. However, the need for patient evaluation is greater with more complex procedures, such as dermabrasion, hair transplantation, flaps, and grafts. Certain underlying physiologic and pathophysiologic problems demand attention and caution. Medications and dietary supplements are often numerous and need to be scrutinized (...) should be allowed to clear before elective procedures are undertaken. The process of hepatic stabilization may take several weeks past the risk period of delirium tremens following alcohol withdrawal. Hepatic function is best assessed by the clinical status, the return of transaminase levels to baseline, and/or a repeat biopsy of the liver. A natural decline in hepatic function occurs with age, which is important with respect to drug metabolism. The amide class of anesthetics (eg, lidocaine

2014 eMedicine.com

28. Pigmented Villonodular Synovitis

. Radiation therapy may be used as the primary treatment method or in concert with surgical excision. Preferred examination Clinical information and plain radiographs are not always sufficient to establish a correct diagnosis. findings are characteristic, but not pathognomonic, for this disorder. Rarely, biopsy is required to establish preoperative tissue diagnosis. Plain radiographs demonstrate signs similar to joint effusion or soft-tissue swelling. Calcifications are not a usual feature of PVNS. Rarely (...) sheath. Anteroposterior plain film of the foot shows a circumferential mass, which is more apparent on the medial aspect of the proximal phalanx of the great toe. Note the degenerative cystic changes at the interphalangeal joint of the great toe. Mild saucerization or pressure erosion of the medial cortex of the proximal phalanx is seen. Giant cell tumor of tendon sheath. Axial T1-weighted magnetic resonance imaging (MRI) scan of the foot shows intermediate signal mass surrounding the proximal

2014 eMedicine Radiology

29. Juxtacortical Tumors (Treatment)

to enlargement of the lesion or from impingement on adjacent soft-tissue structures. On physical examination, the mass is painful, firm, and immobile. [ ] Radiographically, periosteal chondromas demonstrate variable mineralization within the lesion. A shell of new bone formation from the overlying periosteum may also be present (see the first image below). The underlying bone cortex usually is scalloped (saucerization) with various degrees of sclerosis. [ ] Cortical sclerosis is well marginated but may (...) . The possibility of higher-grade areas within dedifferentiated parosteal osteosarcoma lesions emphasizes the need for adequate sampling of the tumor at biopsy. This constitutes the dedifferentiated variant of parosteal osteosarcoma. By virtue of its low-grade nature, as seen histologically, parosteal osteosarcoma has the best prognosis of any of the variants of surface osteosarcoma, with survival rates of 80% at 20 years postoperatively in the Memorial-Sloan-Kettering series [ ] and 90% at 5 years

2014 eMedicine Surgery

30. Juxtacortical Tumors (Overview)

to enlargement of the lesion or from impingement on adjacent soft-tissue structures. On physical examination, the mass is painful, firm, and immobile. [ ] Radiographically, periosteal chondromas demonstrate variable mineralization within the lesion. A shell of new bone formation from the overlying periosteum may also be present (see the first image below). The underlying bone cortex usually is scalloped (saucerization) with various degrees of sclerosis. [ ] Cortical sclerosis is well marginated but may (...) . The possibility of higher-grade areas within dedifferentiated parosteal osteosarcoma lesions emphasizes the need for adequate sampling of the tumor at biopsy. This constitutes the dedifferentiated variant of parosteal osteosarcoma. By virtue of its low-grade nature, as seen histologically, parosteal osteosarcoma has the best prognosis of any of the variants of surface osteosarcoma, with survival rates of 80% at 20 years postoperatively in the Memorial-Sloan-Kettering series [ ] and 90% at 5 years

2014 eMedicine Surgery

31. Corneal Problems - Non Acute

. Microbiological investigations - a corneal scrape (clinic) or biopsy (theatre) may be helpful. Preservative-free ocular lubricants or artificial tears are a good first step in helping to relieve initial discomfort whilst awaiting specialist review. Pain can be addressed with oral analgesics; topical anaesthetics should be avoided as they are toxic to the corneal epithelium if used repeatedly. Acute corneal problems Corneal injury The cornea copes well with minor injuries or abrasions. If it is scratched (...) from the chronic irritation. Other disorders Mooren's ulcer - this is an ulcerative condition (usually unilateral) which arises as a result of an autoimmune response to corneal antigens. [ ] It is rare but serious, particularly in young Africans in whom an aggressive form is seen. Treatment depends on the subtype (ranges from topical steroids/antibiotics to aggressive systemic steroid treatment). Dellen - localised saucer-shaped thinning of the cornea caused by localised tear film instability

2008 Mentor

32. Melanoma Detection by Oblique-Incidence Optical Spectroscopy

of the imaging is over, your lesion(s) will be biopsied. Your study doctor will decide which lesions require this kind of treatment as part of your standard care. Depending on what the study doctor decides, you will have either saucerization biopsies or excisional biopsies. A saucerization biopsy removes the entire lesion by cutting under it in a "scoop-like" manner. An excisional biopsy "cuts away" the entire lesion along with part of the surrounding skin. A pathologist will receive your biopsied tissue (...) Details Study Description Go to Brief Summary: Primary Objectives: To establish a statistically significant database: With Spectroscopic Oblique-Incidence Reflectometry (OIR) experimental system, we will obtain OIR spatio-spectral images of 1,000 human skin non-melanocytic and melanocytic lesions that, based on clinical diagnosis, are routinely biopsied and submitted for histopathologic diagnosis and of the adjacent normal skin for self-referencing. The experimental database will contain demographic

2007 Clinical Trials

33. Variation in the diagnosis, treatment, and management of melanoma in situ: a survey of US dermatologists. (PubMed)

). To aid in clinical assessment, respondents reported using a magnifying lens (57.4%) and dermoscopy (17.4%). Most dermatologists preferred excisional and saucerization biopsies as the method of choice for sampling. A large percentage of physicians (78.9%) preferentially used dermatopathologists for the evaluation of the majority of pigmented lesions. Although most respondents would not unquestioningly accept a benign pathology diagnosis when there was a clinical suspicion of MIS, 16.1% would accept

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2005 Archives of Dermatology

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