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Utilization of Mohs Micrographic Surgery for Benign Adnexal Tumors of the Skin: A Systematic Review
Drake Carter1, Mojahed Mohammad K Shalabi2, Alexander D Woods3
1Chicago Medical School, Rosalind Franklin University, North Chicago, Illinois.
Background:
Mohs micrographic surgery (MMS) is primarily utilized for the treatment of malignant skin cancers. However, benign adnexal tumors of the skin (BATS) sometimes present as large, locally aggressive, or cosmetically disfiguring lesions that may benefit from the tissue-sparing, margin-controlled benefits of MMS to ensure complete clearance with satisfactory aesthetic outcomes.
Objective:
To present a systematic review of the clinical presentation and reported outcomes of BATS treated by MMS.
Materials And Methods:
A systematic review was performed using the databases PubMed, EMBASE, and Web of Science to identify cases where BATS were treated with MMS. From the eligible articles, clinical details were extracted, as well as stated rationale for choosing MMS as the surgical intervention.
Results:
Thirty-one articles were included describing 85 BATS treated with MMS. Tumors represented included trichoblastoma, desmoplastic trichoepithelioma, hidradenoma, chondroid syringoma, spiradenoma, cylindroma, desmoplastic trichilemmoma, papillary eccrine adenoma, pilomatrixoma, proliferating trichilemmal tumor, and tubular apocrine adenoma. Most tumors were located on the head/neck and were treated by MMS due to large size, aggressive behavior, recurrence after prior excision, or cosmetically sensitive location.
Conclusion:
Although BATS are not currently described in the appropriate use criteria for MMS, certain clinical scenarios may justify the use of MMS when treating these tumors.
