Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm
CPT4 code
Name of the Procedure:
Destruction of Malignant Lesion (e.g., Laser Surgery, Electrosurgery, Cryosurgery, Chemosurgery, Surgical Curettage) on Scalp, Neck, Hands, Feet, Genitalia; Lesion Diameter 3.1 to 4.0 cm
Summary
This procedure involves the removal of cancerous skin lesions from sensitive areas like the scalp, neck, hands, feet, or genitalia. Techniques can include laser surgery, electrosurgery, cryosurgery, chemosurgery, or surgical curettage. The chosen method depends on the specific case and lesion characteristics. Lesions being treated measure between 3.1 and 4.0 cm in diameter.
Purpose
Medical Condition or Problem:
To eliminate malignant (cancerous) skin lesions to prevent the spread of cancer.
Goals or Expected Outcomes:
Complete removal of the malignant tissue to achieve a cancer-free state at the site of the lesion and to reduce the risk of metastasis.
Indications
Specific Symptoms or Conditions:
- Diagnosed malignant skin lesions on the scalp, neck, hands, feet, or genitalia.
- Lesion size between 3.1 and 4.0 cm in diameter.
Patient Criteria or Factors:
- Confirmed diagnosis of skin cancer.
- Lesions located in sensitive or functionally important areas.
Preparation
Pre-Procedure Instructions:
- Fasting may be required if general anesthesia is needed.
- Medication adjustments as directed by the physician.
- Avoidance of blood-thinning medications.
- Specific cleansing of the area may be required the night before.
Diagnostic Tests or Assessments:
- Biopsy to determine malignancy.
- Imaging studies if deeper tissue involvement is suspected.
- Blood tests to evaluate overall health status.
Procedure Description
Step-by-Step Explanation:
- Anesthesia: Local anesthesia to numb the area; general anesthesia if necessary for extensive lesions.
- Marking: The lesion area is marked for precision.
- Destruction Method:
- Laser Surgery: Directed laser beams to vaporize the lesion.
- Electrosurgery: Electric currents to burn and destroy the lesion.
- Cryosurgery: Extreme cold (liquid nitrogen) to freeze and destroy the lesion.
- Chemosurgery: Application of chemical agents to kill cancer cells.
- Surgical Curettage: Scraping away the lesion with a curette.
- Closure: Depending on the method, the area may be left open to heal naturally or closed with stitches.
- Dressing: Application of a sterile dressing to protect the area.
Tools, Equipment, or Technology:
- Lasers, electrosurgery units, cryotherapy devices, chemicals, curettes.
Anesthesia or Sedation:
- Local or general anesthesia depending on the size and location of the lesion.
Duration
Typically, the procedure takes 30 minutes to 1 hour, depending on the method and size of the lesion.
Setting
Performed in an outpatient clinic, surgical center, or hospital.
Personnel
- Dermatologist or surgeon
- Nurses
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
Common Risks:
- Pain
- Infection
- Bleeding
- Scarring
Rare Risks:
- Nerve damage
- Excessive bleeding
- Recurrence of the lesion
Management:
- Pain management with medications.
- Infection prevention with antibiotics.
- Regular follow-up to monitor healing.
Benefits
Expected Benefits:
- Removal of malignant tissue.
- Prevention of cancer spread. ##### Realization of Benefits:
- Healing typically observed within a few weeks to months, based on the method used.
Recovery
Post-Procedure Care:
- Keep the area clean and dry.
- Follow specific wound care instructions.
- Avoid strenuous activities until fully healed.
Expected Recovery Time:
- Usually 2 to 4 weeks, depending on the method used and patient’s healing capacity.
Restrictions or Follow-up Appointments:
- Attend all follow-up appointments for evaluation and monitoring.
- Report any signs of infection or complications immediately.
Alternatives
Other Treatment Options:
- Surgical excision.
- Radiation therapy.
Topical treatments.
Pros and Cons:
- Surgical excision: More invasive but might be more definitive in some cases.
- Radiation therapy: Non-invasive but requires multiple sessions.
- Topical treatments: Least invasive but may be less effective for deeper lesions.
Patient Experience
During the Procedure:
- Numbness at the site due to anesthesia.
Some pressure or mild discomfort.
After the Procedure:
- Mild to moderate pain managed with pain-relief medications.
- Possible swelling and redness.
- Gradual healing with proper care.
- Regular follow-up for checking on the healing process and ensuring no recurrence.