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What protocol do you follow when performing staged excision with paraffin sections for the treatment of cutaneous melanoma?

If you perform MART-1 staining, what protocol do you follow?
1 Answer
Mednet MemberInvited Expert
Dermatology · Baylor College Of Medicine
Answered on

Our surgical protocol is as follows:

  1. Place marking sutures at 12 and 6-o'clock on debulk, margins, and patient (more marking sutures if a big tumor).
  2. Take a central debulk with 1-3mm margins around visible tumor (+/- Woods lamp) for breadloaf sections. Depth of excision is down to superficial fat. This tissue is to assess true depth of invasion.
  3. Take margins, including deep fat, as if it were a regular Mohs stage (bowl-shaped).
  4. Gross, ink, and map the tissue for margins as a regular Mohs layer ...

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