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Mohs Micrographic Surgery for Advanced Centrofacial Tumors.
Ivy I Norris1, Christine H Weinberger2, Todd E Holmes2
1Private Practice, Northwest Dermatology, Spokane, Washington.
Summary
Mohs surgery effectively treats complex midfacial skin cancers, even those invading bone or recurring. Careful planning and a multidisciplinary approach are crucial for successful outcomes in challenging cases.
Area of Science:
- Dermatology
- Surgical Oncology
- Head and Neck Surgery
Background:
- Mohs micrographic surgery (MMS) is a specialized technique for skin cancer removal.
- Advanced centrofacial tumors present significant surgical challenges due to their location and potential for extensive tissue involvement.
Observation:
- A review of 15 years of complex midface cases treated with MMS was conducted.
- Twenty cases involving tumors extending to bone, recurrent lesions, and perineural disease were analyzed.
Findings:
- MMS demonstrated success in treating extensive and challenging midfacial tumors.
- Careful surgical planning, meticulous technique, and expert reconstruction are vital for optimal results.
- Two patients experienced disease-related mortality, highlighting the severity of some advanced cases.
Implications:
- Mohs surgery is a viable option for extensive midfacial lesions, potentially treating tumors deemed inoperable by other means.
- A multidisciplinary approach, including imaging and adjuvant therapies, is often necessary for complex cases.
- Diligent follow-up is essential, as regional recurrence and metastasis can occur despite clear margins.
