Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; 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 Curettage); Scalp, Neck, Hands, Feet, Genitalia; Lesion Diameter 1.1 to 2.0 cm
Summary
This is a medical procedure to remove malignant (cancerous) skin lesions using various techniques like laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettage. It targets lesions on sensitive areas such as the scalp, neck, hands, feet, and genitalia that are between 1.1 to 2.0 cm in diameter.
Purpose
The purpose of this procedure is to eliminate cancerous skin lesions, preventing the spread of malignant cells and promoting healthy tissue regrowth. The ultimate goal is to treat skin cancer effectively while preserving as much normal tissue as possible.
Indications
- Presence of malignant skin lesions.
- Lesions located on the scalp, neck, hands, feet, or genitalia.
- Lesions that have a diameter between 1.1 to 2.0 cm.
- Biopsy-proven malignancy.
Preparation
- The patient may need to fast for a few hours if sedation is planned.
- Adjustments to medications, particularly blood thinners.
- Diagnostic tests like biopsies, blood tests, or imaging studies may be required to plan the procedure.
Procedure Description
- The area is cleaned and prepped.
- Local anesthesia is administered to numb the area. Sedation may be used for larger or multiple lesions.
- Depending on the chosen method:
- Laser Surgery: A laser is used to vaporize the lesion.
- Electrosurgery: Electrical currents burn and destroy the lesion.
- Cryosurgery: Liquid nitrogen freezes and destroys the lesion.
- Chemosurgery: Chemical agents are applied to destroy the malignant cells.
- Surgical Curettage: A curette (surgical instrument) scrapes off the lesion.
- The wound area is treated to promote healing and avoid infection.
Duration
The procedure typically takes 30 to 60 minutes, depending on the size and number of lesions.
Setting
It is commonly performed in an outpatient clinic, surgical center, or hospital.
Personnel
- Dermatologist or Surgeon
- Nursing staff
- Anesthesiologist (if sedation is required)
Risks and Complications
- Infection
- Bleeding
- Scarring
- Pain or discomfort
- Recurrence of the lesion
- Rare complications may include allergic reactions to anesthesia or extensive scarring.
Benefits
- Effective removal of cancerous lesions
- Preservation of surrounding healthy tissue
- Minimally invasive with a relatively quick recovery time
- Immediate visualization of results
Recovery
- Keep the wound clean and dry.
- Follow-up appointments to monitor healing and ensure complete removal of malignant cells.
- Avoid strenuous activities and sun exposure to the treated area.
- Recovery time is usually a few weeks, but it may vary based on the treatment method and individual healing response.
Alternatives
- Mohs Surgery: Highly precise technique for removing skin cancer layer by layer.
- Radiation therapy: Uses high-energy rays to target cancer cells.
- Topical medications: Creams or gels for superficial cancers.
- Pros and cons of these alternatives vary, depending on lesion size, location, and patient health.
Patient Experience
- Mild discomfort or pain during and after the procedure, usually manageable with over-the-counter pain relievers.
- The treated area might appear red and swollen initially but should improve within days.
- Peace of mind from effective treatment of malignant skin lesions.