Use of the “spaghetti” technique for surgical treatment of lentigo maligna

Lentigo maligna (LM) is a melanoma in situ that commonly presents as a macula with progressive and irregularly pigmented growth, especially in the face of elderly people with sun-damaged skin. This melanoma in situ has a risk (30-50%) of progression to lentigo maligna melanoma. Complete surgical exc...

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Main Authors: Gabriela Suemi Shimizu, Farid Bark Hamdar, Claudio Henrique Santana Tavares dos-Santos, Luiz Augusto Daloia Souza, Fernando Henrique Sgarbi Parro, Ivan Dunshee de Abranches Oliveira Santos, Christiane Steponavicius Sobral, Eduard René Brechtbühl
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2019-03-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/2361/en_v34n1a24.pdf
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author Gabriela Suemi Shimizu
Farid Bark Hamdar
Claudio Henrique Santana Tavares dos-Santos
Luiz Augusto Daloia Souza
Fernando Henrique Sgarbi Parro
Ivan Dunshee de Abranches Oliveira Santos
Christiane Steponavicius Sobral
Eduard René Brechtbühl
author_facet Gabriela Suemi Shimizu
Farid Bark Hamdar
Claudio Henrique Santana Tavares dos-Santos
Luiz Augusto Daloia Souza
Fernando Henrique Sgarbi Parro
Ivan Dunshee de Abranches Oliveira Santos
Christiane Steponavicius Sobral
Eduard René Brechtbühl
author_sort Gabriela Suemi Shimizu
collection DOAJ
description Lentigo maligna (LM) is a melanoma in situ that commonly presents as a macula with progressive and irregularly pigmented growth, especially in the face of elderly people with sun-damaged skin. This melanoma in situ has a risk (30-50%) of progression to lentigo maligna melanoma. Complete surgical excision of the lesion requires margins of at least 10 mm, even for lesions in situ. However, when the growth of LM occurs in areas of aesthetic or functional implications (face, neck, and soles), the excision is often reduced to preserve important anatomic structures and for cosmetic purposes. Moreover, the peripheral margins may be clinically ill-defined and not always pigmented, and thus, such cases are associated with underestimated extension and risk of insufficient resection. The "spaghetti" technique, described by Gaudy Marqueste, is a strategic surgical approach based on sampling of a range of "spaghetti-like" strips to determine the margins of the lesion prior to removal of the tumor. After the pathological confirmation of neoplasia-free margins, the main central lesion is resected, allowing reconstruction of the defect in the same procedure, as an alternative to Mohs micrographic surgery.
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publishDate 2019-03-01
publisher Thieme Revinter Publicações Ltda.
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series Revista Brasileira de Cirurgia Plástica
spelling doaj-art-dd68ef3b4e684ea984879158c98f230d2025-08-20T02:51:27ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352019-03-01340115115510.5935/2177-1235.2019RBCP0024Use of the “spaghetti” technique for surgical treatment of lentigo malignaGabriela Suemi Shimizu0Farid Bark Hamdar1Claudio Henrique Santana Tavares dos-Santos2Luiz Augusto Daloia Souza3Fernando Henrique Sgarbi Parro4Ivan Dunshee de Abranches Oliveira Santos5Christiane Steponavicius Sobral6Eduard René Brechtbühl7Hospital dos Defeitos da Face, Cruz Vermelha de São Paulo, São Paulo, SP, BrazilHospital dos Defeitos da Face, Cruz Vermelha de São Paulo, São Paulo, SP, BrazilHospital dos Defeitos da Face, Cruz Vermelha de São Paulo, São Paulo, SP, BrazilHospital dos Defeitos da Face, Cruz Vermelha de São Paulo, São Paulo, SP, BrazilA.C. Camargo - Cancer Center, São Paulo, SP, BrazilA.C. Camargo - Cancer Center, São Paulo, SP, BrazilHospital dos Defeitos da Face, Cruz Vermelha de São Paulo, São Paulo, SP, BrazilA.C. Camargo - Cancer Center, São Paulo, SP, BrazilLentigo maligna (LM) is a melanoma in situ that commonly presents as a macula with progressive and irregularly pigmented growth, especially in the face of elderly people with sun-damaged skin. This melanoma in situ has a risk (30-50%) of progression to lentigo maligna melanoma. Complete surgical excision of the lesion requires margins of at least 10 mm, even for lesions in situ. However, when the growth of LM occurs in areas of aesthetic or functional implications (face, neck, and soles), the excision is often reduced to preserve important anatomic structures and for cosmetic purposes. Moreover, the peripheral margins may be clinically ill-defined and not always pigmented, and thus, such cases are associated with underestimated extension and risk of insufficient resection. The "spaghetti" technique, described by Gaudy Marqueste, is a strategic surgical approach based on sampling of a range of "spaghetti-like" strips to determine the margins of the lesion prior to removal of the tumor. After the pathological confirmation of neoplasia-free margins, the main central lesion is resected, allowing reconstruction of the defect in the same procedure, as an alternative to Mohs micrographic surgery.http://www.rbcp.org.br/export-pdf/2361/en_v34n1a24.pdflentigomelanomaexcision marginsreconstructive surgical proceduresnose
spellingShingle Gabriela Suemi Shimizu
Farid Bark Hamdar
Claudio Henrique Santana Tavares dos-Santos
Luiz Augusto Daloia Souza
Fernando Henrique Sgarbi Parro
Ivan Dunshee de Abranches Oliveira Santos
Christiane Steponavicius Sobral
Eduard René Brechtbühl
Use of the “spaghetti” technique for surgical treatment of lentigo maligna
Revista Brasileira de Cirurgia Plástica
lentigo
melanoma
excision margins
reconstructive surgical procedures
nose
title Use of the “spaghetti” technique for surgical treatment of lentigo maligna
title_full Use of the “spaghetti” technique for surgical treatment of lentigo maligna
title_fullStr Use of the “spaghetti” technique for surgical treatment of lentigo maligna
title_full_unstemmed Use of the “spaghetti” technique for surgical treatment of lentigo maligna
title_short Use of the “spaghetti” technique for surgical treatment of lentigo maligna
title_sort use of the spaghetti technique for surgical treatment of lentigo maligna
topic lentigo
melanoma
excision margins
reconstructive surgical procedures
nose
url http://www.rbcp.org.br/export-pdf/2361/en_v34n1a24.pdf
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