Variations for Special Locations and Large, Deep Penetrating Tumors
In this chapter, the excision of tumors growing at special locations such as nose, lips, eyelid, and ear will be discussed. The natural border of the anatomy of these tissues restrains the possibilities for tumor outgrowths and also limits the surgical options to remove the margin. Also, surgery at these locations or the division of the tumor tissue might require special care as the skin can be very thin or very inflexible. Additionally, the excision and division workup of very large tumors which might also penetrate deeper tissues like bones will be described in this chapter in detail. Here particularly, the deep penetration of tumors into other tissues such as bone tissue requires special attention as a full 3D histological workup might not be possible or straightforward. It should be noted that as before, all combinations of excision variations and embedding are freely exchangeable and are only chosen as exemplification. As always, the ultimate goal for all procedures is the full recovery of the entire 3D margin of the tumor specimen for histological evaluation and the following application of these findings onto the respective 3D defect. In this chapter, the plane of the embedded margins and the corresponding histological slide are presented in a simplified margin scheme.