Dermatologic SurgeryMicrocystic adnexal carcinoma: Treatment with Mohs micrographic surgery
Section snippets
Method
This is a prospective, non-comparative, multi-center, interventional case series of patients with MAC treated with MMS in Australia and monitored by the Skin and Cancer Foundation, between 1993 and 2002. All patients were treated by an accredited Mohs surgeon, using standard fresh-frozen MMS techniques. Data was collected by the Skin and Cancer Foundation.
The criteria for selection were all cases with MAC diagnosed histologically and treated with MMS. The following parameters were recorded:
Statistical analysis
Associations between categorical variables were analyzed using chi-square tests, with the Mantel-Haenszel test for linear association where appropriate. The Wilcoxon signed rank test was used for non-normally distributed data. Exact 95% confidence intervals (CI) were calculated for the recurrence rates. Analyses were performed using SAS Version 8.2 (SAS Institute Inc, Cary, NC).
Results
Forty-four patients with 44 tumors were included in the study. There were 21 males and 23 females; mean age was 54 ± 19 years (median, 55.5 years; range, 10-86 years). Forty out of the 44 tumors (90.9%) were located in the head and neck area, mainly on the cheek (12 patients, 27.3%) and nose (9 patients, 20.5%). Only 4 tumors were located outside the head and neck area (9.1%) (Table I). The most common reason for referral for MMS was tumor type (26 patients, 59.1%) (Table II).
Tumor age before
Discussion
Malignant skin adnexal tumors arising from sweat glands are not common. MAC is a slowly growing, locally aggressive tumor that was recognized as a specific clinical entity as recently as 1982.1 The rarity of this tumor, the pattern of growth, and its fairly recent description, has resulted in only a small number of publications evaluating the best treatment options. Our study, to the best of our knowledge, is the largest prospective series reporting the effectiveness of MMS in treating MAC.
The
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Funding sources: None.
Conflicts of interest: None identified.