Treatment and Outcomes of Malignant Melanoma of the Eyelid

Number of excisions required to obtain clear surgical margins and prognostic value of AJCC T category for patients with eyelid melanoma

“…In the periocular region, a 5-mm margin of excision for thin (≤1 mm) eyelid melanomas has been recommended, given the desire to preserve vital tissues and ocular function 3. Several studies have shown that frozen section technique is unreliable for evaluating surgical margins for melanoma 4 5. In up to 33% of cases, margin status has been falsely read as negative on frozen sections when it is positive on permanent sections 4.…”

Predicting the Surgical Margin of Resection in Periocular Cutaneous Neoplasms and the Significance of Reconstruction Following Mohs Micrographic Surgery

“…12 The use of MMS for treatment of melanoma in situ, sebaceous cell carcinoma, and merkel cell carcinoma has been well described, but still remains controversial. 3,[13][14][15][16][17][18] Wide surgical excision with or without the use of prophylactic elective lymph node dissection, radiotherapy, or chemotherapy may be considered the more accepted practice for these more aggressive tumors. 3,[19][20][21][22] Many reports have described the use of a 2 mm to 5 mm margin of resection (MOR) for treatment of periocular nonmelanoma skin cancers.…”

Modified Mohs Micrographic Surgery for Periocular Melanoma and Melanoma In Situ: Long-Term Experience at Scripps Clinic

“…Two other studies using margin-control techniques in the treatment of periocular melanoma reported recurrence rates of 7.4% at 32 months of follow-up and 17.2% at 36 months (Table 4). 4,23 In summary, we report a case series in the excision of periocular melanoma using rush, permanent, paraffin-embedded tissue sections for 100% margin control. This series is among the largest and of longest duration available in the literature.…”

“…3 The LM/LMM subtype is more common in the periocular area than in other cutaneous locations but has a similar prognosis when depth of invasion is considered. 1,4,5 Surgical excision with meticulous margin control has been advocated for the treatment of head and neck melanoma, including periocular melanoma, because of a high recurrence rate and the importance of tissue conservation in this region. 3,6 Margin-control options include traditional Mohs micrographic surgery (MMS) with frozen sections with or without immunostains, MMS with paraffin-embedded tissue sections, and paraffin-embedded tissue sections with vertical rather than tangential processing.…”