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Related Experiment Videos

Malignant melanoma re-excision specimens--how many blocks?

H M Martin1, A J Birkin, J M Theaker

  • 1Department of Histopathology, Southampton General Hospital, UK.

Histopathology
|May 29, 1998
PubMed
Summary

Histological examination of wide excision specimens for cutaneous melanoma rarely detects residual cancer when the initial excision was complete. Current sampling methods are adequate, suggesting revised handling guidelines can reduce pathology department workload.

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Area of Science:

  • Dermatology
  • Pathology
  • Surgical Oncology

Background:

  • Wide local excision is a standard treatment for cutaneous melanoma.
  • Pathologists exhibit variability in handling and sampling wide excision specimens.
  • The clinical utility of extensive tissue sampling requires evaluation.

Purpose of the Study:

  • To assess the diagnostic yield of reexcision specimens in cutaneous melanoma.
  • To evaluate the impact of histological sampling on detecting residual melanoma.
  • To propose evidence-based guidelines for handling wide excision specimens.

Main Methods:

  • Retrospective analysis of 219 cutaneous melanoma cases.
  • Assessment of macroscopic appearance, tissue block sampling, and residual melanoma detection.

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  • Statistical evaluation of sampling adequacy.

    • Main Results:

    • Residual melanoma was found in only 4 of 167 completely excised cases.
    • Detected residual disease indicated advanced local disease or incomplete excision of radial growth.
    • Sampling variation (1-12 blocks) did not correlate with missed residual lesions.

    Conclusions:

    • Detecting residual melanoma in wide excision specimens is uncommon and offers limited clinical value.
    • Random tissue block sampling without macroscopic abnormalities is not clinically useful.
    • Revised handling guidelines can optimize resource utilization in histopathology.