Adelaide Plastic Surgery

GP Information Regarding Skin Cancers

Skin Cancer
Skin Cancer

Skin Lesions

All information is taken from the Cancer.org website, with thanks.

Advice
Referral to a specialist should be considered when there is:

  • Uncertainty of diagnosis
  • Any doubt about appropriate treatment
  • A tumour larger than 1cm
  • Frequent multiple tumours, for example, organ transplant patients, Gorlinís syndrome
  • Recurrent tumours, despite treatment
  • Incompletely excised tumours, especially when complete excision may be difficult
  • Recommended treatment beyond the skills of the practitioner
  • Anticipation of difficulty with technique or anatomy
  • Squamous cell carcinoma on the lip or ear
  • Infiltrating or scar-like morphoeic basal cell carcinoma, particularly those on the nose or around the nasolabial fold because there may be a problem in determining the tumourís extent and depth
  • Cosmetic concerns, such as lesions of the upper chest and upper arms where keloid scarring is a potential problem
  • Areas where palpable regional lymph nodes are suggestive of metastatic spread of squamous cell carcinoma, especially head and neck, axilla and groin
  • Organ transplant and other chronically immunosuppressed patients are best referred to organ transplant clinics.

Surgical—Refer to a Plastic Surgeon.
Surgical or laser excision (where appropriate) is performed as a day surgery procedure, usually under local anaesthesia.

Adelaide Plastic Surgery has a broad range of clinical lasers which may offer a less invasive method of dealing with certain lesions.

Sarcoma & Soft Tissue Tumours

Soft tissue sarcoma accounts for approximately 1% of all cancers and can arise anywhere in the body.

Sarcoma should be suspected if a soft tissue mass is:

  • larger than 5cm (approximately the size of a golf ball)
  • growing (particularly rapidly)
  • deep to, or attached to, deep fascia.

Delays in referral to specialist sarcoma units are common, sometimes lengthy, and may have adverse consequences for subsequent patient management and outcomes.

For suspected bone and soft tissue tumours in the extremities a MRI with intravenous contrast is usually required (and rebatable if requested by a specialist). CT is usually preferred for intra-abdominal sarcoma. Further imaging and biopsy should only performed after review by an oncologic surgeon or other member of a sarcoma team.

Advising our staff of the possible diagnosis at the appointment time will ensure the patient is seen within one or two working days.

Investigation
Further investigations will be discussed and arranged with the patient during the initial consultation. Ultrasound can be a useful initial investigation, but further imaging such as PET, CT chest and/or biopsies are usually performed on an individualized basis and reviewed in specialized multi-disciplinary forum.

Surgical—Refer to Associate Professor Susan Neuhaus.

For further information:
http://wiki.cancer.org.au/australia/Guidelines:Sarcoma
www.australiansarcomagroup.org