Original articleFavorable long-term outcomes in patients with histologically dysplastic nevi that approach a specimen border
Section snippets
Methods
The study was approved by the Mayo Clinic Institutional Review Board. Retrospective review of our Medical Index for appropriate codes adapted from the International Classification of Diseases, Eighth Revision, of all melanocytic lesions diagnosed as either “junctional nevus” or “compound nevus” that were removed from patients residing in Olmsted County, who were evaluated in the Department of Dermatology at Mayo Clinic, Rochester, Minn, between January 1, 1980, and December 31, 1989, was
Results
Between 1980 and 1989, 3398 specimens were diagnosed as junctional nevus or compound nevus (Fig 1). Our histopathologic review revealed that 1179 of 3398 nevi approached a microscopic border, and we identified 117 of 1179 (10%) that would be diagnosed as HDN by current criteria. Two of these 117 were excluded, because review of the medical records indicated that the specimens were incisional biopsies. Of the 115 HDNs that met all 4 inclusion criteria, 66 were graded as mildly dysplastic, 42 as
Discussion
Our goal was to answer the question: if a patient receives a diagnosis of HDN approaching a microscopic border and re-excision is not performed, what is the long-term risk of melanoma developing at that site? Our study demonstrates that incomplete or narrow removal of HDNs does not appear to be associated with development of melanoma at the site or with metastatic melanoma during an average follow-up period of nearly 2 decades. Other investigators, with smaller case series and/or shorter
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Conflicts of interest: None declared.