BACKGROUND: There is significant debate over the use of frozen section processing in Mohs micrographic surgery (MMS) for melanoma. Opponents argue that individual melanocytes are too subtle to view consistently on frozen sections. On the other hand, proponents state that (1) melanocytes are visible on well-prepared frozen sections and (2) MMS using frozen sections for evaluation of melanoma surgical margins achieves comparable recurrence rates when compared with MMS using paraffin-embedded, permanent sections. OBJECTIVE: To introduce a new immunohistochemical (IHC) staining protocol that consistently produces melanoma frozen section slides in 1 hour that are easily evaluated during MMS. METHODS: We adapted a polymer-based IHC staining protocol to use with MMS frozen sections for the evaluation of melanoma surgical margins. RESULTS: When used with antibody directed against MART-1 for frozen section evaluation of melanoma, the section staining is reproducible and specific for melanocytes. CONCLUSIONS: In contrast to current IHC protocols that are time consuming (2 to 2.5 hours), we present a new frozen section protocol that takes approximately 1 hour to perform. This technique benefits patients, histotechnicians, and surgeons.
BACKGROUND: There is significant debate over the use of frozen section processing in Mohs micrographic surgery (MMS) for melanoma. Opponents argue that individual melanocytes are too subtle to view consistently on frozen sections. On the other hand, proponents state that (1) melanocytes are visible on well-prepared frozen sections and (2) MMS using frozen sections for evaluation of melanoma surgical margins achieves comparable recurrence rates when compared with MMS using paraffin-embedded, permanent sections. OBJECTIVE: To introduce a new immunohistochemical (IHC) staining protocol that consistently produces melanoma frozen section slides in 1 hour that are easily evaluated during MMS. METHODS: We adapted a polymer-based IHC staining protocol to use with MMS frozen sections for the evaluation of melanoma surgical margins. RESULTS: When used with antibody directed against MART-1 for frozen section evaluation of melanoma, the section staining is reproducible and specific for melanocytes. CONCLUSIONS: In contrast to current IHC protocols that are time consuming (2 to 2.5 hours), we present a new frozen section protocol that takes approximately 1 hour to perform. This technique benefits patients, histotechnicians, and surgeons.
Authors: Sheila M Valentín-Nogueras; David G Brodland; John A Zitelli; Lorena González-Sepúlveda; Cruz M Nazario Journal: Dermatol Surg Date: 2016-06 Impact factor: 3.398