Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over 4.0 cm
CPT4 code
Name of the Procedure:
Destruction of Malignant Lesion
Common Name: Removal of cancerous skin lesion
Technical Terms: Laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement
Summary
In this procedure, a malignant (cancerous) skin lesion measuring over 4.0 cm in diameter is removed using methods like laser, electricity, freezing, chemicals, or surgical scraping. This helps eliminate cancerous cells from the affected area of the trunk, arms, or legs.
Purpose
This procedure is performed to treat skin cancer by destroying malignant cells in a specific area. The goal is to remove the lesion completely to prevent the cancer from spreading and to promote healing of the surrounding skin.
Indications
- Diagnosed with malignant skin cancer
- Presence of a cancerous lesion over 4.0 cm in diameter on the trunk, arms, or legs
- Symptoms may include changes in skin appearance, such as a growing lesion, irregular borders, or bleeding
Preparation
- Patients may need to fast for a few hours prior to the procedure
- Adjustments in medication, especially blood thinners, may be required
- An initial assessment and possibly a biopsy to confirm the malignancy
- Pre-procedure blood tests and imaging studies may be necessary
Procedure Description
- The patient is positioned in a comfortable manner, and the area around the lesion is cleaned and sterilized.
- Depending on the method used:
- Laser Surgery: A concentrated beam of light is used to burn away the lesion.
- Electrosurgery: Electric currents are used to cut and destroy cancerous tissues.
- Cryosurgery: Liquid nitrogen is applied to freeze and kill the malignant cells.
- Chemosurgery: Strong chemicals are applied to destroy the lesion.
- Surgical Curettement: A curette (a surgical instrument resembling a small spoon) is used to scrape away the lesion.
- Local anesthesia is administered to numb the area, or in some cases, general anesthesia may be used.
- The destroyed tissue is then removed, and the site is treated to promote healing and prevent infection.
Duration
The procedure typically takes about 30 minutes to 1 hour, depending on the size of the lesion and the method used.
Setting
This procedure is usually performed in an outpatient clinic, hospital, or surgical center.
Personnel
- Dermatologist or surgical oncologist
- Nurse or medical assistant
- Anesthesiologist, if general anesthesia is used
Risks and Complications
- Common risks: Infection, bleeding, scarring, or pain at the site
- Rare risks: Nerve damage, allergic reactions to anesthesia, incomplete removal of the lesion
Benefits
- Complete removal of the cancerous lesion
- Reduced risk of cancer spreading
- Potential improvement in skin appearance and health
- Benefits are often realized within a few weeks as the area heals
Recovery
- Patients are usually able to go home the same day
- Instructions may include keeping the area clean and dry, possible use of antibiotic ointments, and pain management
- Avoid strenuous activities until fully healed
- Follow-up appointments to monitor healing and ensure no recurrence of the lesion
Alternatives
- Mohs surgery, a precise surgical technique to remove cancerous tissue layer by layer
- Radiation therapy to target and destroy cancer cells
- Topical treatments and creams for less invasive management
- Each alternative has its own set of advantages and limitations which should be discussed with the healthcare provider
Patient Experience
- Patients may feel mild discomfort or a stinging sensation during the application of local anesthesia
- Post-procedure, patients might experience pain, swelling, or redness at the treated site
- Pain can be managed with over-the-counter pain relievers, and the patient will be advised on wound care for optimal recovery