Microcystic adnexal carcinoma: an unpredictable aggressive neoplasm

Microcystic adnexal carcinoma is a rare, locally aggressive cutaneous neoplasm that has been recently recognized as a distinct entity. Typically it appears as a papular, flesh-colored mass on the face of women patients. Because of its benign appearance, it is often present for months or years before diagnosis. Histologically, there is a paucity of mitotic figures and other criteria usually associated with aggressive lesions. In this article we discuss 3 cases of microcystic adnexal carcinoma, each presenting as a small, localized lesion but all requiring extensive surgical extirpation with margin control using the Mohs tissue resection technique.