Megasession: excision of numerous skin cancers in a single session

A large number of synchronous skin cancers in a patient may be managed with extensive removal in one session or limited removal in several sessions.

Our objective was to prospectively evaluate the experiences of patients undergoing excisional surgery for multiple nonmelanoma skin cancers in one session.

Patients scheduled for excision of five or more skin lesions in one operative session were prospectively surveyed and followed for outcomes. Patients were surveyed immediately postoperatively and 7 and 90 days postoperatively.

Ten patients were prospectively enrolled. They had a previous history of numerous skin cancers (median 76; range 4-551). The median number of lesions excised was 8 (range 5-21). All patients received local anesthesia, 90% received sedation, and none had general anesthesia. The median duration of the procedure was 480 minutes. Nine patients tolerated the procedure well. Two patients were electively hospitalized for observation because of the extent of surgery. Nine patients were very satisfied with the megasession.

Carefully selected patients with extensive skin cancer can tolerate excisional surgery of a large number of cutaneous neoplasms in one session, with few and readily managed complications. Most of our patients preferred extensive tumor removal in one session to removal of fewer tumors in several sessions.