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Skin tumors (or lesions) are spots or growths on the skin that can take very different shapes, sizes and colors depending on the case. There are many types of tumors, ranging from a simple mole (nevus) to a rare tumor that is difficult to diagnose, which can be present on the body from birth or appear over time. They are often diagnosed by your primary care doctor or dermatologist, who refer you to a plastic surgeon to have them removed (surgical excision).

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1. Benign tumors and malignant tumors

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The \"soft tissue\" category covers all body tissues other than bones and organs: muscles, fat, fibrous tissue, blood vessels. Tumors can develop in these tissues and must be treated by surgical excision.

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Three types of tumors can be distinguished:

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Benign tumors (not serious)

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These may be excised when they are likely to progress toward malignancy (excision is then performed as a preventive measure). Benign lesions may also be excised if they are bothersome (causing friction and irritation due to their location) or because they are unsightly.

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There are several common forms of benign tumors:

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Suspicious tumors

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During a visual examination, it is not always possible to diagnose whether a lesion is benign or malignant. In such cases, they undergo microscopic examination after surgical removal to confirm the diagnosis. The benign tumors described above can be considered \"suspicious\" whenever their appearance is unusual.

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Any suspicious skin tumor or lesion should be examined by a doctor able to perform a histological examination (tissue examination). Only a doctor can diagnose whether a tumor is benign or malignant and advise you on appropriate treatments. If you notice a lump or lesion, it is important to see a doctor quickly, as the prognosis depends on how early the diagnosis and treatment occur.

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Malignant tumors

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These tumors correspond to skin cancers and must, in most cases, be surgically removed by excision. The excision is performed with a \"safety margin\" around the tumor to limit the risk of recurrence. These may include epitheliomas, melanomas or sarcomas.

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Soft tissue sarcomas are a type of cancer that is difficult to diagnose due to their wide variety and rarity. Unlike sarcomas, benign tumors are generally superficial and small (under 5 cm). A sarcoma can be diagnosed by the appearance of a mass developing in soft tissue, more often in the limbs than in the trunk, neck or head.

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2. Principle of a tumor excision

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An excision is a surgical procedure that involves removing an element harmful to the body (a tumor, organ, or foreign body).

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In the case of benign tumors, surgical excision removes skin lesions for aesthetic reasons or due to functional discomfort. When the excision is performed for strictly aesthetic reasons, it is important to discuss the potential scarring impact of the procedure with the surgeon.

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Removing a tumor, even a benign one, requires very great precision, as the excision must be performed with a sufficient margin around the tumor to avoid any risk of recurrence. The sufficient margin around the tumor varies depending on the lesion being treated, hence the importance of a pre-operative diagnosis.

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In the case of simple excisions, the procedures end with the placement of sutures. In the case of lesions requiring a deeper excision, repair of the tissue loss is necessary (flap techniques, skin grafting).

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The procedure lasts between 20 minutes and two hours depending on the type of skin lesion treated.

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The procedure is generally performed under local anesthesia and on an outpatient basis.

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Following the procedure, a piece of the removed skin is sent to a laboratory for examination to confirm that the excision is sufficient and that the resection margins are indeed within healthy tissue.

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3. Recovery after skin tumor excision

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Recovery after excision of a benign skin tumor is generally simple, although vigilance is needed in case of unusual signs (swelling with redness, abnormal sensitivity, onset of purulent discharge).

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A post-operative histological analysis confirms that the excision is complete and benign.

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Strict medical follow-up is necessary to monitor healing and any recurrence. The development of skin tumors at another location can occur, particularly in cases of basal cell carcinoma. Skin monitoring performed by the referring doctor or a dermatologist helps detect early forms of tumors.

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Itching is fairly common during the first few days of the healing phase.

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As long as the scar is still dark, prolonged sun exposure should be avoided, or \"full-spectrum\" sun protection should be used.

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Several months (or even one or two years) are needed to assess the final appearance of the scar.

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An excision is a surgical procedure that carries the risks inherent to anesthesia and to the surgical procedure.

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Smoking increases the risk of surgical complications in any type of surgery. Stopping smoking 6-8 weeks before the procedure eliminates this additional risk. If you smoke, talk to your doctor, surgeon and anesthesiologist, or call a smoking cessation helpline to help reduce risks and give yourself the best chances.

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> SOFCPRE factsheet \"Skin tumor surgery\"

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