Microcystic adnexal carcinoma: Treatment with Mohs micrographic surgery

Leibovitch, Igal; Huilgol, Shyamala C.; Selva, Dinesh; Lun, Karyn; Richards, Shawn; Paver, Robert

doi:10.1016/j.jaad.2004.10.868

Cited by 121 publications

(134 citation statements)

References 26 publications

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“…The aggressive and locally invasive nature of the disease results in high recurrence rates, ranging from 15-60% depending on the treatment modality, with lower rates of recurrence observed following Mohs micrographic surgery (21)(22)(23)(24). However, such data may be an overestimate, with misdiagnosis often occurring at the time of excision, and positive margins can occasionally be misread.…”

Section: Discussionmentioning

confidence: 99%

Microcystic adnexal carcinoma in a non-Caucasian patient: A case report and review of the literature

et al. 2016

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Abstract. Microcystic adnexal carcinoma (MAC) is extremely rare among Asians, with the majority of cases presenting in Caucasian individuals. The current study describes the case of a 38-year-old Chinese woman who presented with a 10 year history of a mass in the upper lip. A biopsy resulted in a diagnosis of MAC. The patient underwent complete surgical resection and the tumor was successfully excised. During 6 months of follow-up, there was no evidence of recurrence. To the best of our knowledge, the present case is the first Chinese case to be reported in the English literature, and is presented with the aim of increasing the awareness and aiding in the management of MAC in non-Caucasian populations. IntroductionMicrocystic adnexal carcinoma (MAC) was originally defined in 1982 (1), and is now also termed sclerosing sweat duct carcinoma (2). MAC is a rare, slow-growing, locally aggressive tumor of the eccrine sweat glands, and is characterized by pilar and eccrine differentiation (3). Sweat gland malignancies, combining all types, are particularly rare, accounting for 0.005% of all malignant epithelial neoplasms (4), with a total of ~350 cases currently described in the English literature. It has been reported that the preferential location for the development of this neoplasm is the head and neck region (5).When referring to the English literature, it is evident that MAC primarily affects the Caucasian population, with only two cases occurring in non-Caucasian patients (6,7). Fang et al (8) described two cases involving Chinese individuals in the Chinese literature; however, to the best of our knowledge, there are no cases of Chinese patients with MAC currently reported in the English literature. The present study reviewed all patients that were referred to the Hainan Province People's Hospital (Haikou, China) between January 1994 and January 2014, and identified only one patient with a MAC diagnosis. This case is described herein along with a review of the relevant literature. Case reportA 38-year-old woman was referred to the Department of Oral and Maxillofacial Surgery at the Hainan Province People's Hospital with a mass on the left upper-lip that had been present for >10 years (Fig. 1). During physical examination, it was noted that the tumor was positioned in the left-upper lip and subnasal region. The lesion was a firm, solitary mass, and measured 2x1 cm in size. No submandibular or cervical lymph nodes were palpable during the physical examination. Abdominal ultrasonography and computed tomography (CT; Brilliance iCT; Philips Medical Systems, Amsterdam, Holland) of the head, neck and thorax demonstrated no evidence of systemic or local metastasis. As presented in Fig. 2, the head and neck CT scans revealed the lesion located in the subcutaneous tissue of the left-upper lip, with a wide base inseparable from overlying skin.An incisional biopsy was performed with the patient under local anesthesia. The diagnosis of the specimen was confirmed as carcinoma. The patient underwent complete surgical resection...

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Section: Discussionmentioning

confidence: 99%

Microcystic adnexal carcinoma in a non-Caucasian patient: A case report and review of the literature

et al. 2016

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“…Following the final filling of the expander, the expander was removed and an extensive resection of the tumor was performed. A 0.5-cm tumor-free margin surrounding the skin lesion was identified and excised using MMS (9). Immediate reconstruction was performed using an expanded rotational forehead skin flap (Figs.…”

Section: Case Reportmentioning

confidence: 99%

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Zhou

Zhao

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Microcystic adnexal carcinoma (MAC) is a rare and locally aggressive adenocarcinoma with low-grade malignancy. The present study describes the first reported case and treatment of a Chinese male with a MAC located on the nasal dorsum and nosewing. A 44-year-old man presented with a nasal deformity caused by local repeated infections following an accidental injury to the nose 20 years previously. The nose had been injured by a brick, and treatment at a local hospital 12 years previously had resulted in a nasal scar and a gradually enlarging mass. A physical examination revealed a hypertrophic deformity of the nose and an indurated scar plaque, measuring 2.0x2.0 cm, on the nasal dorsum and nosewing. Microscopic examination revealed a tumor consisting of solid cell nests and a cystic structure with a capsular space. In addition, ductal cells of an adnexal cell origin were visible in the outer epithelium. The medial portion exhibited a microductal structure and invasion of deeper tissues without evident atypia. The tumor cells presented normal nuclear to cytoplasmic ratios and minimal mitotic activity. Pathological examination verified that the tumor was a MAC of low-grade malignancy. A complete surgical resection was performed via Mohs micrographic surgery (MMS), and reconstruction was achieved using an expanded rotational forehead skin flap. No tumor recurrence was detected after a three-year follow-up period. Therefore, for effective treatment of similar MAC cases, complete surgical resection using MMS is recommended, and successful reconstruction may be achieved using an expanded skin flap.

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“…O diagnóstico entre carcinoma basocelular e carcinoma basoescamoso é exclusivamente realizado pelo estudo histológico, através de biópsias incisionais , pois uma biópsia superficial ou de fragmento diminuto não evidenciam os dois tipos histológicos no mesmo tumor, atingindo índices de até 74% nos diagnósticos iniciais 13 . Sendo assim, recomenda-se o estudo da peça proveniente do procedimento cirúrgico, para diagnóstico mais fidedigno.…”

Section: Discussão Discussão Discussão Discussão Discussãounclassified

“…Leibovitch et al 13 , demonstraram uma série de 178 casos no segmento da cabeça e pescoço, quando tratados inicialmente com exérese cirúrgica. As recidivas locais ocorreram em 47,8% dos pacientes, sendo que aproximadamente 70% apresentavam uma segunda recidiva.…”

Section: Discussão Discussão Discussão Discussão Discussãounclassified

“…Na presença de infiltração perineural presente no carcinoma basoescamoso, há maiores índice de morbi-mortalidade, denotando pior prognóstico, especialmente nas lesões localizadas da cabeça e pescoço 17,19,20 . Vários casos com presença de infiltração perineural (69%) ao exame histológico são recidivas locais de tumores previamente tratados 13 . Outro fator de prognóstico desfavorável é a presença de linfonodos regionais comprometidos pela neoplasia.…”

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Tumor de colisão de pele do pescoço

Chedid

Menezes

Aikawa

et al. 2011

Rev. Col. Bras. Cir.

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ABSTRACT ABSTRACT ABSTRACTThe collision or mixed tumor is a malignant neoplasm of the skin related to sun exposure and incidence rates of up to 1.5%. It displays a distinctive clinical behavior in relation to other malignancies of the skin and the histological diagnosis, characterized by the collision between a basal cell carcinoma and squamous cell carcinoma, i.e., two malignancies with distinct histologies and sharp interface between them. The case reported was of a male, 73-year-old patient, with two cervical lesions progressively growing in recent months. The chosen treatment was surgery. Histological examination showed the presence of squamous cell carcinoma adjacent to basal cell carcinoma. These tumors preferentially occur in light-skinned men in the fifth or sixth decades of life. Their most common location is in the head and neck, especially in the central part of the face. The differential diagnosis of basal-squamous carcinoma is defined by distinct histological criteria, since both tumors have similar clinical behavior. Local recurrence rates vary from 12% to 45%, whereas regional ones are of approximately 7.5%. The main prognostic factors are gender, surgical margins, perineural infiltration and lymph node status. The treatment of choice is resection, radiotherapy being indicated as adjuvant or to inoperable lesions. Local recurrence is the main limiting factor in disease-free survival, with poor results.

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Microcystic adnexal carcinoma: Treatment with Mohs micrographic surgery

Cited by 121 publications

References 26 publications

Microcystic adnexal carcinoma in a non-Caucasian patient: A case report and review of the literature

Microcystic adnexal carcinoma in a non-Caucasian patient: A case report and review of the literature

Treatment of nasal microcystic adnexal carcinoma with an expanded rotational forehead skin flap: A case report and review of the literature

Tumor de colisão de pele do pescoço

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