Auricular malignant neoplasms. When is chemotherapy (Mohs' technique) necessary?

Area of Science:

• Dermatology
• Surgical Oncology

Background:

• Auricular malignant neoplasms pose a risk of recurrence.
• Conventional surgical excision margins may be insufficient for certain lesions.

Purpose of the Study:

• To evaluate the adequacy of conventional surgical excision margins for auricular malignant neoplasms.
• To compare conventional excision with Mohs' technique for auricular tumors.

Main Methods:

• Prospective study of 71 auricular malignant neoplasms.
• Marking of conventional excision margins followed by Mohs' technique excision.
• Comparison of defect size between conventional and Mohs' techniques.

Main Results:

• Conventional excision would have been inadequate for 13% of small (<1 cm) and up to 33% of large (>1 cm) primary or recurrent lesions.
• Morpheaform basal cell carcinoma was frequently inadequately excised.
• Mohs' technique resulted in smaller defects than conventional excision would have.

Conclusions:

• Mohs' technique is superior to conventional excision for auricular malignant neoplasms, especially for morpheaform basal cell carcinoma and larger lesions.
• Consider Mohs' technique for high-risk auricular tumors to minimize recurrence and defect size.