From: Proceedings 10th World Congress of Cryosurgery
Lentigo Malignant Melanoma

November 1998
J.M. Fernandez - Vozmediano M.D.

The malignant melanoma is a tumor with a high metastasic capacity and an aggressive behaviour, which at the moment does no react in a regular way nor to chemotherapy treatments neither to the therapy with interferon. Due to this fact, it is considered that the only efficient therapeutical solution is surgical excision with a security margin of 2 cm if possible.

The lentigo maligno melanoma is a premalignant multifocal lesion with a complicated treatment. Some therapeutical proceedings have been described, some of the quite questionable such as radiotherapy., 5-fluoracil topical and Mohs micrographic surgery, being conventional surgery the chosen technique by most of the authors; however, cryosurgery should be a technique to be taken into account nowadays, since it is based on a fact usually considered as a secondary effect of the technique, the selective destruction of the melanocyte, which provokes a residual achromia.

The technique is based on the application of probes in order to create a freezing front with 3-5 mm deep, a security margin of 5mrn an effective temperature of 50-C and making a double cycle of fast freezing and slow defrosting. A healing of 96. 1 % is foreseen when analyzing 206 cases.

Our experience is composed by tow cases of lentigo maligno melanoma which had already changed from radial growth to vertical growth or nodular melanoma. Both with a wide surface. We proceeded in both cases to the removal of the nodules and to apply cryosurgery to the rest of the lesion. The results have been absolutely satisfactory and they have been controlled for five years with no sign of tumor persistence. There exist numerous bibliographical data.


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