The role of frozen section in the diagnosis and management of malignant melanoma

Abstract

Abstract Provided that the pathologist is experienced, frozen section diagnosis of suspected malignant melanoma of the skin is remarkably accurate. Not only can the pathologist diagnose malignancy but he can often indicate the level of invasion of the dermis by the tumour cells. This is a most important prognostic sign and guides the surgeon in his further management of the patient. The use of a cryostat is considered essential to allow better study of the cytological changes. The main indications for the technique are to make a precise diagnosis when there is suspicion of a malignant melanoma, and to confirm the clinical diagnosis before deciding on the extent of surgery. Its use in small tumours and for the detection of lymph node metastases is not advocated. A series of 329 frozen sections from 316 patients with an accuracy rate of 98·8 per cent is reported.