Related Experiment Videos
Mohs micrographic surgery using HMB-45 for a recurrent acral melanoma
1Desert Samaritan Medical Center, Mesa, Arizona, USA.
Summary
Mohs micrographic surgery with HMB-45 immunostaining effectively treated recurrent acral melanoma. This method aids in accurate margin assessment for difficult-to-diagnose melanomas on the sole.
Area of Science:
- Dermatology
- Surgical Oncology
- Pathology
Background:
- Acral melanomas are rare skin cancers on the palms and soles.
- The thick stratum corneum complicates margin assessment, especially for amelanotic or hypopigmented lesions.
- Recurrent acral melanoma presents significant treatment challenges.
Observation:
- This study details the use of Mohs micrographic surgery combined with frozen sections and HMB-45 immunostaining.
- The technique was applied to a multiply recurrent acral melanoma previously unresponsive to standard and Mohs surgery.
- The surgical margins were meticulously evaluated during each stage of excision.
Findings:
- Complete excision of the acral melanoma was achieved in 11 Mohs stages.
- The resulting surgical defect encompassed a significant portion of the plantar foot and toes.
- No melanoma recurrence was observed during a 22-month follow-up period.
Implications:
- HMB-45 immunostaining is a valuable tool for assessing surgical margins in melanoma cases.
- Combining HMB-45 with specific histologic features improves diagnostic accuracy for challenging melanomas.
- This approach offers a promising strategy for managing complex acral melanoma cases.