Simple excision with frozen or permanent sectioning for margin evaluation. This traditional surgical treatment usually relies on surgical margins ranging from 3 to 10 mm, depending on the diameter of the original tumor. Electrodesiccation and curettage. This is a quick method for destroying the tumor, but the adequacy of treatment cannot be assessed immediately since the surgeon cannot visually detect the depth of microscopic tumor invasion. It should be reserved for very small primary tumors since this disease has metastatic potential.
Cryosurgery is used for clinically well defined in situ tumors.
It is especially useful for debilitated patients with medical conditions that preclude other types of surgery. However, the absolute contraindications for cryosurgery include patients with abnormal cold tolerance, cryoglobulinemia, cryofibrinogenemia, Raynaud's disease, and platelet deficiency disorders. Relative contraindications to cryosurgery include tumors of the scalp, ala nasi, nasolabial fold, tragus, postauricular sulcus, free eyelid margin, upper lip vermillion border, and lower legs. Caution should also be employed before treating nodular ulcerative neoplasia greater than 3 cm, carcinomas fixed to the underlying bone or cartilage, tumors situated on the lateral margins of the fingers and at the ulnar fossa of the elbow, or recurrent carcinomas following surgical excision. There is significant morbidity associated with the use of cryosurgery.