ORIGINAL ARTICLE: PDF Only

Usefulness of the Dissecting Microscope in the Surgical Management of Skin Cancers

SHUM, DAVID T. MB, FRCP(C)¹; GUENTHER, LYN C. MD, FRCP(C)¹; VISWANATHA, DAVID MD¹

¹ Department of Pathology, Division of Dermatology, Faculty of Medicine, The University of Western Ontario, London, Ontario Canada.

Address correspondence and reprint requests to David T. Shum, M.B., Department of Pathology, Victoria Hospital, 375 South Street, London, Ontario Canada N6A 4G5.

The Journal of Dermatologic Surgery and Oncology 20(4):p 266-271, April 1994. | DOI: 10.1111/j.1524-4725.1994.tb01623.x

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Abstract

Dermatopathological examination of excised skin cancers serves the dual purposes of defining the nature of the malignancies and evaluating the resection margins for evidence of tumor involvement. Conventional histological techniques, including horizontal frozen sections as prescribed in Mohs micrographic surgery to evaluate resection margins, can often be tedious and not without many pitfalls. In this study, the use of a stereoscopic dissecting microscope is compared with routine microscopy in the examination of 54 skin specimens resected with the clinical diagnosis of cancer. Our results show that the dissecting microscope is more efficient and as accurate in diagnosing basal and squamous cell carcinomas, and in detecting tumor involvement of resection margins. The ability to visualize marginal surfaces in three dimensions allows for a thorough examination and quick localization and mapping of the involved sites. Tissue artifacts due to fixation, freezing, or sectioning are nonexistent. With the lower cost and ease of operation, we suggest that the dissecting microscope is a more superior instrument. Its usefulness in the surgical management of skin cancers should be emphasized and further validated.