With its bones pushing out against its skin, its complexion the ash-gray of death, and its eyes pushed back deep into their sockets, the Wendigo looked like a gaunt skeleton recently disinterred from the grave. What lips it had were tattered and bloody ... Unclean and suffering from suppuration of the flesh, the Wendigo gave off a strange and eerie odor of decay and decomposition, of death and corruption. In Ojibwe, Eastern Cree, Westmain Swampy Cree, Naskapi, and Innu lore, wendigos are often described as giants that are many times larger than human beings, a characteristic absent from myths in other Algonquian cultures. Whenever a wendigo ate another person, it would grow in proportion to the meal it had just eaten, so it could never be full. Therefore, wendigos are portrayed as simultaneously gluttonous and extremely thin due to starvation. The wendigo is seen as the embodiment of gluttony, greed, and excess: never satisfied after killing and consuming one person, they are constantly searching for new victims. A wendigo need not lose the humans powers of cognition or speech and in some depictions may clearly communicate with its prospective victims or even threaten or taunt them.
As the lentigo maligna is often very large, it often merges with, or encompasses other skin tumors – such as lentigines, melanocytic nevi, and seborrheic keratosis. Second dilemma is the biopsy technique. Even though excisional biopsy (removing the entire lesion) is ideal, and advocated by pathologists; practical reason dictates that this should not be done. These tumors are often large and presenting on the facial area. Excision of such large tumor would be absolutely contraindicated if the lesions identity is uncertain. The preferred method of diagnosis is by using a punch biopsy, allowing the physician to sample multiple full thickness pieces of the tumor at multiple sites. While one section of the tumor might show benign melanocytic nevus, another section might show features concerning for severe cellular atypia. When cellular atypia is noted, a pathologist might indicate that the entire lesion should be removed. It is at this point that one can comfortably remove the entire lesion, and thus confirm the final diagnosis of lentigo maligna. The size of the punch biopsy can vary from 1 mm to 2 mm, but it is preferable to use a punch 1.5 mm or larger. Representative samples of the most atypical parts of the nevus should be biopsied, often guided by dermatoscopy. Treatment
The best treatment of lentigo maligna is not clear as it has not been well studied.Standard excision is still being done by most surgeons. Unfortunately, the recurrence rate is high (up to 50%).