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Staged excision of lentigo maligna and lentigo maligna melanoma: a 10-year experience. Plast Reconstr Surg 2009 Dec;124(6):1947-1955



Pubmed ID




Scopus ID

2-s2.0-74049111465 (requires institutional sign-in at Scopus site)   62 Citations


BACKGROUND: The treatment of lentigo maligna and lentigo maligna melanoma presents a difficult problem for clinicians. Published guidelines recommend a 5-mm excision margin for lentigo maligna and a 1-cm margin for lentigo maligna melanoma, yet these are often inadequate. The authors' purpose is to report their 10-year experience using staged excision for the treatment of lentigo maligna and lentigo maligna melanoma of the head and neck.

METHODS: Staged excision was performed on 59 patients over a 10-year period. Data on patient demographics, lesion characteristics, and treatment were collected through an institutional review board-approved chart review.

RESULTS: Using staged excision, 62.7 percent of patients required a 10-mm or greater margin to achieve clearance of tumor. Two or more stages of excision were required in 50.9 percent of patients. Invasive melanoma (lentigo maligna melanoma) was identified in 10.2 percent of patients initially diagnosed with lentigo maligna. There was one (1.7 percent) documented recurrence during a median 2.25-year follow-up period (range, 0 to 10.17 years).

CONCLUSIONS: Staged excision is an effective treatment for lentigo maligna and lentigo maligna melanoma. Previously published recommendations of 5-mm margins for wide local excision are inadequate for tumors located on the head and neck.

Author List

Bosbous MW, Dzwierzynski WW, Neuburg M


William W. Dzwierzynski MD Professor in the Plastic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged, 80 and over
Biopsy, Needle
Cohort Studies
Follow-Up Studies
Hutchinson's Melanotic Freckle
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Retrospective Studies
Risk Assessment
Second-Look Surgery
Skin Neoplasms
Surgical Procedures, Operative
Time Factors
Treatment Outcome