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(Figure 1 ). The defect was closed by a combination of Z-plasties and rhomboid ñaps (Figure 2). The initial cosmetic result was acceptable (Figure 3). Eyebrow tattooing and scar dermabrasion followed, with good effect. There has been no recurrence after 2 years. PATHOLOGIC FINDINGSThe surgical excision of skin and subcu¬ taneous tissue displayed an asymmetric, poorly circumscribed tumor that was broader than it was deep. There was no continuity of the lesion with the surface epithelium. Tumor extended into the deeper dermis, subcutaneous tissues, and muscle (Figure 4

Mi crocyst i c adnexal carcinoma is an uncommon cutaneous tumor with multiple synonyms. On cursory microscopic examination, the tumor mimics syringoma and other benign skin adnexal tumors. However, the asymmetric, infiltrative growth pattern clearly sets the lesion apart as carcinoma. The tumor is locally aggressive, with recurrences common, but regional metastases are rare. Histogenesis is controversial. Optimal treatment consists of complete surgical excision with clear surgical margins.

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