How would you approach an ulcerative non-melanomatous skin cancer of the lower extremity s/p Mohs surgery with gross disease left behind?
The lesion is still ulcerative despite wound care for two months. Would you treat immediately or wait for healing? Would hyperbaric oxygen to heal fully prior to radiation be advised?
Answer from: Radiation Oncologist at Community Practice
If there is gross disease, then the wound is less likely to heal. Need to explore surgery with flap or RT as definitive management.
Comments
Radiation Oncologist at Mountain Radiation Oncology Curious why Mohs was undertaken if not grossly res...
Agreed, this is strange to me. If the resection wa...
The key is to understand why there is gross disease left behind. If the patient is not a surgical candidate, then one must explore alternative therapies depending on the diagnosis. The ulceration will not resolve if the cancer is not addressed.
Answer from: Radiation Oncologist at Community Practice
I want to answer the million-dollar question on why Mohs surgery left remaining residual disease and provide further insight into this case. In addition, I want to thank everyone for their expertise. This is an elderly patient with a pretibial basal cell carcinoma for several years, first treated wi...
Comments
Ok, what about Erivedge neoadjuvantly?
Radiation Oncologist at Mayo Clinic Rochester Thank you! Your timely response is very appreciate...
Radiation Oncologist at Sask Cancer Agency If Erivedge does not result in complete response, ...
Radiation Oncologist at Vanderbilt-Ingram Cancer Center Any reason that this patient cannot receive defini...
Answer from: Radiation Oncologist at Academic Institution
Surgery, if possible to avoid RT (unlikely). Otherwise, definitive RT with the understanding that an amputation may be in the cards. Electively treat inguinal nodes.
Curious why Mohs was undertaken if not grossly res...
Agreed, this is strange to me. If the resection wa...