Mohs Surgery Outside Usual Indications: A Review.

Area of Science:

• Dermatology
• Surgical Oncology

Background:

• Literature supporting Mohs micrographic surgery (MMS) for rare tumors is growing but limited.
• Existing studies often focus on single malignancies or are based on case reports.

Purpose of the Study:

• To review the application of MMS for rare tumors outside its primary indications.
• To assess the efficacy and safety of MMS in treating a spectrum of uncommon cutaneous malignancies.

Main Methods:

• A comprehensive literature review was conducted using MEDLINE and ClinicalKey® databases.
• The review focused on the use of MMS for atypical fibroxanthoma, microcystic adnexal carcinoma, extramammary Paget's disease, Merkel cell carcinoma, eccrine/poroid neoplasms, trichilemmal carcinoma, leiomyosarcoma, and angiosarcoma.

Main Results:

• Mohs micrographic surgery is infrequently used for these rare tumors due to their low incidence.
• MMS is primarily utilized for tumors located in the facial H-zone and can be performed safely.
• The recurrence rate for tumors treated with MMS was observed to be lower than that of simple or wide local excision.

Conclusions:

• Mohs micrographic surgery demonstrates favorable outcomes for rare cutaneous tumors.
• Increased utilization of MMS for these uncommon malignancies is recommended to potentially improve patient outcomes and reduce recurrence.