Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm
CPT4 code
Name of the Procedure:
Destruction of Malignant Lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettage), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm.
Summary
This procedure involves using various techniques to destroy malignant (cancerous) lesions on specific areas of the body like the scalp, neck, hands, feet, and genitalia. The size of the lesion treated ranges from 0.6 to 1.0 cm in diameter.
Purpose
This procedure targets and eliminates malignant skin lesions to prevent the spread of cancer. The goal is to completely remove the cancerous cells to promote healing and prevent recurrence.
Indications
- Presence of small, malignant skin lesions on the scalp, neck, hands, feet, or genitalia.
- Lesion size between 0.6 and 1.0 cm in diameter.
- Biopsy-confirmed diagnosis of malignancy.
Preparation
- The patient may need to fast for several hours prior to the procedure if general anesthesia is to be used.
- Medications, such as blood thinners, may need to be adjusted.
- Pre-procedure assessments, including blood tests and imaging studies, may be required.
- Local site preparation involves cleaning the area to be treated.
Procedure Description
- The patient is positioned comfortably, and the treatment area is cleansed.
- Anesthesia is administered—local for minor lesions or general for more extensive procedures.
- Depending on the method chosen (e.g., laser, electrosurgery, cryosurgery, chemosurgery, surgical curettage), the appropriate equipment is used to destroy the malignant lesion.
- Laser Surgery: Utilizes concentrated light to burn and destroy the lesion.
- Electrosurgery: Uses electrical currents to cut through tissue and coagulate blood vessels.
- Cryosurgery: Involves freezing the lesion with liquid nitrogen.
- Chemosurgery: Applies chemical agents to dissolve the lesion.
- Surgical Curettage: Scrapes the lesion off with a curette.
- The wound is treated and dressed to facilitate healing.
Duration
Typically, the procedure takes about 30 minutes to an hour, depending on the method used and the size of the lesion.
Setting
The procedure is usually performed in an outpatient clinic or dermatologic surgery center.
Personnel
- Dermatologist or surgical oncologist.
- Nurses and medical assistants.
- Anesthesiologist (if general anesthesia is required).
Risks and Complications
- Common: Pain, swelling, redness, tenderness.
- Rare: Infection, scarring, pigment changes, nerve damage, incomplete removal of the lesion, recurrence of cancer.
Benefits
- Effective removal of malignant skin lesions.
- Minimally invasive with relatively quick recovery.
- Reduces the risk of cancer spread and recurrence.
- Early treatment leads to better cosmetic and functional outcomes.
Recovery
- Post-procedure care includes keeping the wound clean and dry, and monitoring for signs of infection.
- Pain can typically be managed with over-the-counter analgesics.
- Recovery time varies from a few days to a couple of weeks, depending on the method used.
- Follow-up appointments are necessary to ensure complete healing and to monitor for recurrence.
Alternatives
- Surgical excision: More invasive but ensures complete removal.
- Radiation therapy: Non-invasive but may require multiple sessions.
- Topical treatments: Less invasive but may be less effective for larger or deeper lesions.
- Pros and cons of alternatives depend on the patient's overall health, lesion size, location, and preference.
Patient Experience
During the procedure, the patient may feel pressure or mild discomfort at the treatment site. Post-procedure pain is typically mild and can be managed with analgesics. Patients will receive detailed instructions on wound care and signs of complications to monitor. Most patients can resume normal activities within a few days, though strenuous activities may be restricted during the initial healing phase.