Surgical Procedure: Carcinomas and Melanomas

There are different types of skin cancer: carcinomas and melanomas.

Carcinomas :

There are 2 types of carcinomas: superficial basal cell carcinoma and squamous cell carcinoma (nodular basal cell carcinomas).

The first are the most common. They are slow-growing tumors, primarily local, and never metastasize.

The second type is much more aggressive and can metastasize.

Melanomas :

A melanoma is a tumor that develops from melanocytes, the cells responsible for skin pigmentation.

Melanoma accounts for 10% of skin cancers. It can occur at any age but is more commonly seen in individuals who experienced sunburns before the age of 8.

Melanoma is the most serious form of skin cancer and must be removed as quickly as possible.

In general, skin exposed to the sun is most susceptible to skin cancers.

Basal Cell Carcinoma

Basal cell carcinoma is a relatively common malignant skin tumor.

Like all skin tumors, it is promoted by sun exposure. Its growth is slow and it primarily affects patients over the age of 50. It is possible to have multiple skin carcinomas.

This cancer is very treatable once diagnosed.

Its most common form is known as the “pearly pearl.”

Squamous Cell Carcinoma

Squamous cell carcinoma develops from the squamous cells of the skin (the keratinocytes).

To confirm the diagnosis before removal, a biopsy may be performed to examine the cancerous cells.

Additional examinations to assess local or regional spread may be performed. These can include an ultrasound or a CT scan.

Melanomas :

A melanoma is a tumor that develops from melanocytes.

Melanocytes are the cells that give the skin its pigmentation. They produce melanin.

Frequent and repeated sun exposure since childhood is the main risk factor. Repeated sunburns are also significant risk factors.

DIAGNOSING A MELANOMA

The ABCDE rule helps in the diagnosis of melanoma:

• A for Asymmetry;
• B for Irregular Borders;
• C for Heterogeneous or Very Dark Color;
• D for Diameter (size);
• E for rapid Evolution.

MELANOMA TREATMENT

It is essential to perform a melanoma surgery promptly to remove it as quickly as possible. The faster a malignant melanoma is removed, the lower the chances of the cancer spreading. Similarly, the risk of recurrence is reduced.

Your surgeon can remove the tumor through excision (removal using a scalpel) or via photodynamic therapy.

A biopsy excision will be performed to determine the type of lesion and the depth of invasion.

A more comprehensive assessment may be prescribed to evaluate the possibility of local-regional (lymph nodes) or distant spread.

ADDITIONAL TREATMENTS

In addition to surgical removal of the melanoma, additional treatments may be possible:

– Lymph node dissection;

– Chemotherapy or Immunotherapy.

Surgical excision is the most commonly recommended treatment. An esthetic surgeon or a dermatologist can perform this surgery.

Initially, the lesion is visually identified and biopsied for histological diagnosis.

The histological type helps determine the surgical procedure, particularly the excision margins.

Indeed, the safety margin can range from 2 mm to 2 cm depending on the tumor.

Excisional surgery is most often performed under local anesthesia.

Once the tumor is removed, it is sent for histological analysis.

The results of this analysis are usually available within 10 to 15 days. Based on the findings, dermatological follow-up is arranged.