Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm
CPT4 code
Name of the Procedure:
Destruction of Malignant Lesion (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), Scalp, Neck, Hands, Feet, Genitalia; lesion diameter 2.1 to 3.0 cm.
Summary:
This procedure involves the removal of cancerous skin lesions on specific body areas, such as the scalp, neck, hands, feet, or genitalia. The malignant lesion measured between 2.1 to 3.0 cm in diameter can be destroyed using various techniques like laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettement.
Purpose:
The primary purpose is to eliminate cancerous skin lesions, reducing the risk of cancer progression and aiding in overall skin health. The expected outcome is the complete removal of the malignant lesion with minimal impact on the surrounding healthy tissue.
Indications:
- Observable malignant lesions on the scalp, neck, hands, feet, or genitalia.
- Confirmation of malignancy through biopsy or other diagnostic tests.
- Lesion size between 2.1 to 3.0 cm in diameter.
- Patients who have not responded to other treatments or who need an alternative to surgical excision.
Preparation:
- Pre-procedure fasting may be required if general anesthesia is used.
- Adjustments to current medications, particularly blood thinners.
- Pre-procedure imaging or biopsy to confirm lesion characteristics.
- Instructions on skin care and hygiene prior to the procedure.
Procedure Description:
- The patient is positioned for optimal access to the lesion.
- Anesthesia or sedation is administered as needed (local, regional, or general).
- The lesion area is cleaned and sterilized.
- Depending on the method chosen:
- Laser surgery: A concentrated beam of light is used to precisely destroy the lesion.
- Electrosurgery: Electrical currents are applied to excise and destroy the lesion.
- Cryosurgery: Extreme cold, usually from liquid nitrogen, is applied to freeze and destroy the lesion.
- Chemosurgery: Chemicals are applied to break down and destroy cancer cells.
- Surgical Curettement: A curette is used to scrape off the lesion.
- Post-procedure wound care is applied.
- The patient is monitored until stable if sedation or anesthesia was used.
Duration:
The procedure typically takes between 30 minutes to an hour, depending on the technique and complexity.
Setting:
This procedure is usually performed in an outpatient clinic, dermatology office, or surgical center.
Personnel:
- Dermatologist or surgical oncologist
- Nurses or medical assistants
- Anesthesiologist (if sedation or general anesthesia is necessary)
Risks and Complications:
- Common risks: Minor bleeding, infection, scarring.
- Rare risks: Anesthesia reactions, significant tissue damage, incomplete removal requiring further treatment.
- Complications will be managed with antibiotics, wound care, or additional interventions as needed.
Benefits:
- Effective removal of malignant skin lesions.
- Reduced risk of cancer spreading.
- Quick recovery with minimal downtime.
- Improved cosmetic outcomes depending on the technique used.
Recovery:
- Follow-up care instructions including wound care, avoiding certain activities, and monitoring for signs of infection.
- Recovery time varies but generally ranges from a few days to a week.
- Restrictions on heavy lifting or strenuous exercise until healing is confirmed.
- Follow-up appointments to assess healing and ensure complete removal of the lesion.
Alternatives:
- Surgical excision with potential for larger scars.
- Topical treatments or radiation therapy for smaller or less accessible lesions.
- Pros: Possible fewer procedures and complete histologic examination.
- Cons: Longer recovery time, larger scars, or less effective on larger lesions.
Patient Experience:
- During the procedure: Mild discomfort or pain, usually managed with anesthesia.
- After the procedure: Possible soreness, swelling, or redness at the site.
- Pain management: Over-the-counter or prescribed pain relievers as recommended.