One step melanoma surgery (OSMS) for thin melanomas and melanoma in situ: Undoubtedly the perfect and most adequate therapeutic Approach!

We present a 43-year-old female with congenital melanocytic lesion in the area of the left thigh [Figure 1a]. Within the last 1 year, the patient observed a change in the color of the formation and an increase in its size. Within the dermatological examination on the lateral side of the left thigh, the presence of a pigment asymmetric lesion with a size of 1,5/2 cm, clear distortion from healthy tissue at the periphery, loss of pigmentation between 9: 00-11: 00 hours, irregular diameter and significant elevation in the upper two-thirds of the lesion, was observed [Figures 1ab]. Clinically and dermatoscopically (loss of pigment network and presence of pale pink and gray regression areas) data were indicative for melanoma of less than 1 mm or melanoma in situ [Fig. 1a]. Preoperative ultrasound examination of tumor thickness was not performed. The screening was without data for dissemination of the process. An operation was performed by the of One step melanoma surgery (OSMS) method, and the lesion was removed by elliptical excision with a direct surgical field of 1 cm in all directions [Figure 1c-d]. The resulting surgical defect was closed by single interrupted sutures [Figure 1e]. The post-operative histological examination confirmed the initial (clinical/ dermatoscopic) diagnosis, namely that it is melanoma in situ, with clear resection lines. A smooth post-operative period without complications was observed.