Excision of malignant melanoma overlying a pacemaker

BACKGROUND. With the increasing number of patients with implantable cardiac devices, dermatologic surgeons must be increasingly familiar with the types of devices and potential interference by surgical procedures. OBSERVATIONS. We report the excision of a 1 cm malignant melanoma in situ occurring on the skin directly overlying the patient's pacemaker. CONCLUSIONS. Successful excision of malignant lesions in the setting of implantable cardiac devices requires an understanding of pacemaker implantation anatomy following well-established guidelines for electrosurgery in the setting of implantable cardiac devices and careful coordination with cardiac and anesthesia specialists.