3d histology evaluation and our results in non melanoma head and neck skin tumors

Objective Although the probability of diagnosis and treatment of skin tumors are higher than other tumors; face area, which is most commonly involved, has a special importance due the highest aesthetical concerns of the patients. Mohs micrographic surgery, which was first described by Mohs, has been used with success for years. The reported recurrence rates of 3D histology technique, which is a similar technique to Mohs surgery, were around 1-2%. The objective of this study was to study the efficacy of the 3D histology technique in the skin tumors of the face. Method 50 patients, who were operated in the department of Ear Nose and Throat of the Ege University Medical Faculty Hospital between January 2015 and April 2016 due to the basal-cell carcinoma and squamous cell carcinoma, were included in the study. Primarily, the tumor mass was excised according to the tumor size with a safety surgical margin. The 12-o'clock position was labeled with Tipp-ex. Afterward, margin bands with a width of 2mm were divided starting from the 12-o'clock position (to 4 or 6 divisions according to the size of the tumor; 2 divisions in small tumors). The detailed map of the tumor was drawn with an explanation on the form, which was generated together with the pathology department, in order to ease the communication with the pathologist and prevent possible errors. The results of the pathological examination were reported after 24 hours. Findings 18 of the patients were females (36%) and 32 were males (64%). The calculated mean age was 67.6 years (41-93 years). Total 59 lesions were excised in 50 patients. 8 of these 59 lesions were SCC (13.6%) and 51 were BCC (86.4%). The average lesion area was calculated as 4.60cm2 (0.16-36.91) and average defect area as 9.40 cm2 (0.64-56.75). No recurrence was observed during the follow-up period in any patients. Conclusion The limited and sufficient excision of the tumor and most appropriate reconstruction of the defect is the base of the therapy in the skin tumors. However, limited and sufficient excision are not possible to be performed with the standard excision methods. Techniques such as Mohs and 3D histology are the most appropriate approaches to the skin tumors with their low recurrence rates, especially in head and neck tumors.