Dear Dr. Elpern,
The patient is a 91 year-old working lobsterman who was sent in by his GP for evaluation of a large fungating tumour on his left temple. By history, the lesion has been present for 15 years but has only really increased in size in the past 18 months. He's in vigourous good health otherwise.
On close examination, the tumour was found to be on a stalk. It's surface measured around 5 cm in diameter, whilst the pedicle was 9 mm in diameter.
After cleaning the area, I administered local anesthesia with lidocaine and epinephrine and snipped it off. I dissicated the base and applied a dressing.
I may follow-up with imiquimod (as recommended by a dermatologic friend) or may excise the defect secondarily.
We occasionally see dramatic tumours like this is watermen. They are a stoic lot.
I wonder, do your colleagues have any suggestions? I will post the path report when it is ready.
Cheers,
Dr. Hamish Dunwoodie, FRCSC
General Surgeon
Moncton, NB, Canada
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