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Palisaded encapsulated neuroma (PEN) is a rare, benign cutaneous condition characterized by small, firm, non-pigmented nodules or papules. [1] [2] They typically occur as a solitary (single) lesion near the mucocutaneous junction of the skin of the face, although they can occur elsewhere on the body.
A trend has occurred in dermatology over the last 10 years with the advocacy of a deep shave excision of a pigmented lesion. [5] [6] [7] An author published the result of this method and advocated it as better than standard excision and less time-consuming. The added economic benefit is that many surgeons bill the procedure as an excision ...
Even though excisional biopsy (removing the entire lesion) is ideal, and advocated by pathologists; practical reason dictates that this should not be done. These tumors are often large and presenting on the facial area. Excision of such large tumor would be absolutely contraindicated if the lesion's identity is uncertain.
Excision of the entire lesion, with adequate margin, will remove the lesion, allow full tissue diagnosis, and leave a planned surgical wound which can usually be repaired with a good cosmetic result. However, removing the entire lesion (especially on the face) may present difficult problems of plastic reconstruction.
The goal of reconstructive surgery is the restoration of normal appearance and function. The choice of technique in reconstruction is dictated by the size and location of the defect. Excision and reconstruction of facial skin cancers are generally more challenging due to the presence of highly visible and functional anatomic structures in the face.
A parotidectomy is the surgical excision (removal) of the parotid gland, the major and largest of the salivary glands. The procedure is most typically performed due to neoplasms [1] (tumors), which are growths of rapidly and abnormally dividing cells. Neoplasms can be benign (non-cancerous) or malignant (cancerous).
The size of the margin is an important issue in areas that are functionally important (i.e., large vessels like the aorta or vital organs) or in areas for which the extent of surgery is minimized due to aesthetic concerns (i.e., melanoma of the face or squamous cell carcinoma of the penis). [2] The desired size of margin around the tumour can vary.
Surgical excision with a large safety margin is the main treatment for localized amelanotic melanoma. The suggested margin size for amelanotic melanoma is debatable since it varies according to the lesion's development, thickness, and invasion depth. [ 34 ]