Melanoma of the Nose: Prognostic Factors, Three‐Dimensional Histology, and Surgical Strategies

Abstract

This is the largest study of nasal melanomas so far. Excision of LMM using 3D histology allowed the reduction of excision margins for better cosmesis and function. Our results do not permit conclusions regarding the prognostic impact of SLNB.

3D histology-guided surgery for basal cell carcinoma and squamous cell carcinoma: recurrence rates and clinical outcome

“…After rush fixation for 2 h in 60 8C hot formalin, all specimens are embedded in paraffin and sectioned according to routine procedures. Twenty hours later, haematoxylin-eosin stained slides are read by a dermatopathologist or surgeon experienced in the histopathological interpretation of malignant skin tumours [16][17][18]26 .…”

Cutaneous lesions of the nose

“…Jahn et al have published the largest series of malignant melanomas on the nose so far [115]. In their group of 45 patients, they showed a female predisposition of 64.4%, with lentigo maligna melanoma (LMM) being the most frequent subtype (73.3%).…”

“…Some authors prefer the Tuebingen cake technique, whereas other authors prefer classic Mohs surgery [122-124]. Micrographic surgery according to the Tuebingen cake technique has been studied by Jahn and colleagues [115]. It ideally utilizes a cylindrical piece of tissue where the base and the margin of the tumor are assessed separately (Fig.…”

“…Jahn et al conclude from their study data that male patients tend to have fewer recurrences than female patients and that LMM has a better prognosis than other histologic subtypes in patients with stage I and II melanoma of the nose [115]. The authors report recurrence rates of 6.7% with all recurrences observed in female patients.…”

“…Jahn et al further conclude that although tumor thickness is the most important prognostic factor for cutaneous melanoma of the nose, this factor has no significant influence on the prognosis, probably because of the limited number of patients (n = 45). To date all available studies on elective lymph node dissection (ELND) have failed to demonstrate a beneficial effect on patients with cutaneous melanoma of the trunk and extremities; therefore, there is limited evidence to support application of this technique in patients with melanoma of the nose [115,126-128]. Although a sentinel lymph node biopsy (SLNB) is performed in cutaneous melanomas of other localizations with a tumor thickness > 1.00 mm, the available data for patients with melanomas of the nose do not suggest a clear recommendation regarding prognostic impact.…”