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Dysplastic nevus surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Surgery is the mainstay of treatment for dysplastic nevus.

Surgery

Surgery is the mainstay of treatment for dysplastic nevus.

Surgical Margins for Wide Excision of Primary Melanoma

  • The National Comprehensive Cancer Network (NCCN) recommends wide excision of margins of primary melanoma.
  • The choice of clinical margins is based on the tumor thickness.[1]
  • The margins may be individualized to accomodate anatomic and functional considerations.[1]
Tumor thickness Recommended Clinical Margins
In situ 0.5 cm
≤ 1 mm 1 cm
> 1 mm – 2 mm 1-2 cm
> 2 mm – 4 mm 2 cm
> 4 mm 2 cm
A blue stained sentinel axillary lymph node

Complete Lymph Node Dissection

The 2013 National Comprehensive Cancer Network (NCCN) recommends complete dissection of involved nodal basin is recommended.[1]

  • Specific considerations for the groin lymph nodes
  • Indications for iliac and obturator lymph node dissection:
  • Positive pelvic CT, or
  • Cloquet’s node is positive
  • Elective iliac and obturator lymph node dissection
  • Clinically positive superficial node, or
  • ≥ 3 superficial nodes are positive


References

  1. ↑ 1.0 1.1 1.2 Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). “Melanoma, version 2.2013: featured updates to the NCCN guidelines”. J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.

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