Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 1.1 to 2.0 cm
CPT4 code
Name of the Procedure:
Destruction of Malignant Lesion (e.g., Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettement), Trunk, Arms, or Legs; Lesion Diameter 1.1 to 2.0 cm
Summary
This procedure involves the removal or destruction of a malignant (cancerous) skin lesion on the trunk, arms, or legs. Methods may include laser surgery, electrosurgery, cryosurgery (freezing), chemosurgery (chemical application), or surgical curettement (scraping) to eliminate cancer cells.
Purpose
The primary goal is to eradicate cancerous cells from the lesion to prevent the spread of cancer. It aims to completely destroy the malignant tissue while preserving as much healthy skin as possible.
Indications
- Presence of a malignant lesion with a diameter between 1.1 to 2.0 cm.
- Diagnosed skin cancer such as basal cell carcinoma, squamous cell carcinoma, or melanoma.
- Lesions that have not responded to other treatments.
- Patients deemed appropriate candidates for the surgical procedure.
Preparation
- Patients may be advised to stop certain medications like blood thinners a few days before the procedure.
- The area around the lesion may need to be cleaned and sterilized.
- Pre-procedure imaging or biopsy may be conducted to assess the lesion.
Procedure Description
- The patient is positioned comfortably to access the lesion.
- Local anesthesia is administered to numb the area.
- Depending on the method:
- Laser Surgery: A focused light beam is directed to vaporize the lesion.
- Electrosurgery: High-frequency electric currents cut through and coagulate the lesion.
- Cryosurgery: Liquid nitrogen is applied to freeze and destroy the lesion.
- Chemosurgery: Chemicals are applied to dissolve the lesion.
- Surgical Curettement: A curette (spoon-shaped instrument) is used to scrape off the lesion.
- The area is then dressed appropriately.
Duration
The procedure typically takes between 15 minutes to 1 hour, depending on the size and depth of the lesion.
Setting
The procedure is usually performed in an outpatient clinic, dermatologic office, or surgical center.
Personnel
- Dermatologist or surgeon specializing in skin cancer treatments.
- Medical assistants or nurses for support.
- Anesthesiologist if the patient requires sedation.
Risks and Complications
- Common risks include pain, swelling, redness, and minor bleeding.
- Rare risks may involve infection, scarring, changes in skin pigmentation, and incomplete removal of the lesion.
- Complications might be managed with medications, additional procedures, or follow-up visits.
Benefits
- Effective removal of cancerous cells.
- Minimally invasive options available.
- Preservation of surrounding healthy skin.
- Quick recovery times in most cases.
Recovery
- Keep the treated area clean and dry.
- Follow specific wound care instructions provided by the healthcare team.
- Avoid strenuous activities and exposure to sunlight until fully healed.
- Mild discomfort and redness are to be expected; pain relievers may be prescribed.
- Follow-up appointments to monitor healing and ensure complete removal of the lesion.
Alternatives
- Surgical excision: A more invasive procedure with a longer recovery period.
- Radiation therapy: Used when surgery is not feasible, but involves multiple sessions.
- Topical treatments: Less invasive but may take longer to see results and may not be effective for all lesion types.
Patient Experience
- Patients will feel minimal pain during the procedure due to local anesthesia.
- Some discomfort and redness at the treatment site post-procedure.
- Over-the-counter pain relief and comfort measures such as ice packs may be recommended.
- Clear post-care instructions help ensure a smooth recovery process.