Mohs micrographic surgery for superficial leiomyosarcoma: a systematic review

Superficial leiomyosarcoma is a rare malignancy of muscular origin arising in the skin and soft tissues. Although wide local excision is the standard of care for these tumors, Mohs micrographic surgery is a promising treatment option as it provides for optimal margin control. The object of this systematic review is to examine the efficacy of micrographic surgery in the management of superficial leiomyosarcoma. A literature search was conducted using the PubMed/Medline and Cochrane databases; 14 studies representing 66 patients were included. Analysis demonstrated a notably low rate of recurrence (1.5%) and metastasis (0.0%) in tumors treated with micrographic surgery, contrasting with increased rates of recurrence and metastasis in tumors treated with wide local excision. These data may be influenced by a shortage of subcutaneous leiomyosarcoma in the included patients, as subcutaneous tumors are more likely to recur and metastasize. Further research is warranted to determine the value of Mohs micrographic surgery in treating superficial leiomyosarcoma and specifically, the subcutaneous variant.