Blackberry-like lesion of the back: One Step melanoma surgery (OSMS) as possible treatment approach even when melanoma only suspected!?

Abstract

A 42 year old male patient visited the dermatological department with a complaint for suddenly appeared and curious looking lesion in the area of the back (fig. 1a-b). Respectively, the lesion was painless, but caused some cosmetic concerns. According to the anamnestic data several days before the clinical examination the formation has been treated by a surgeon with electrocautery, resulting in а partial remission of the lesion. A tissue sample has not been collected and no histopathological data was available at the time. During the dermatological examination the presence of blackberry like, around 5mm, elevated, lobulated lesion was established in the area of the back (fig. 1a-b). Additionally, circular redness was visualized around the lesion (fig. 1a-b). Based on clinic and dermatoscopy, the possibility of cutaneous hemangioma or melanoma was considered. Surgical removal of the lesion was performed with a direct operational safety margin of 1 cm in all directions. Subsequent histological examination revealed the presence of capillary hemangioma with clear resection lines.