Tattooing in cancer surgery

In advanced cancer of the head and neck combined therapy (radiation, chemotherapy and surgery) may offer a better survival rate than surgery, radiation or chemotherapy alone. Frequently at the completion of preoperative adjuvant therapy, there is considerable regression in the tumor, which obscures the original limits of the tumor. Histologic studies of excised specimens demonstrated nests of viable appearing cells to the periphery of the original tumor. For this reason complete excision of the original tumor with a surrounding margin of normal tissue is necessary. Therefore it is imperative to accurately demarcate the limits of the lesion before radiation or chemotherapy is begun. The permanent tattooing of mucous membrane and skin with India ink has been most satisfactory in recording the size of original lesions. The indications, materials and methods of tattooing are discussed.