Micrographic surgery in the treatment of microcystic adnexal carcinoma

Periocular Microcystic Adnexal Carcinoma: A Case Report and a Major Review

“…Of 59 patients with known information, the median symptom duration was 3 years (average 7, range 0–50 years). Of patients with available information, most tumors presented as brown-to-reddish (5/18, 28%) 32,54,57,59,62 or pearly white-to-waxy (7/18, 39%) 8,24,33,40,52,58,68 nodules (37/68, 54%) 2,3,5,9,11,14–16,19,23–26,32,33,35,37,43,46,48,52,54,56,59,66,67,69 or plaques (20/68, 29%) 8,13,17,18,21,22,24,28,29,42,47,54,58,59,61–63,68 that were ill-defined, sclerotic, or indurated (20/51, 39%) 3,13,25,26,32,33,42,46,47,56,57,59,62,63,68 with firm consistency (19/51, 37%), 2,8,13,23,24,28,36,37,47,54,56,68 10 mm or greater in size (33/46, 72%). 3,6,11,13,14,17,18,24,25,29,35,37,42,47,…”

“…Eighty-six of 93 (92%) tumors originated in the periocular skin, most commonly in the eyebrow (26/86, 30%) [12][13][14]17,18,20,22,23,[25][26][27]29,30,36,37,43,47,48,53,[59][60][61]67 followed by the lower eyelid (20/86, 23%). 2,8,11,13,32,33,35,39,40,49,54,56,58,59,62 Fifteen of 86 (17%) tumors involved more than 1 region. Primary orbital/periorbital involvement at presentation was reported in 11 of 86 (13%) patients, associated with diplopia in 3 patients.…”

“…MAC was accurately diagnosed in 25 of 70 (36%) patients with available information. On incisional biopsy, MAC frequently simulated another malignant neoplasm, most commonly basal cell carcinoma (14/70, 20%) 3,6,12,20,21,24,33,39,44,57,60 and squamous cell carcinoma (13/70, 19%), 2,3,5,6,31,42,48,62 or as a benign adnexal tumor, such as trichoepithelioma (4/70, 6%) and syringoma (3/70, 4%). 11,29,61 A non-neoplastic process, such as inflammation and fibrosis was diagnosed in 5 of 70 (7%) cases (Table 2).…”

“…Review of the literature identified 92 patients fulfilling the inclusion criteria for this study in addition to our current patient, for a total of 93 patients with MAC. 2,3,5,8,9,11–69 Patient demographics and presenting characteristics are summarized in Table 1.…”

“…Information on the duration of follow-up was available on 64 of 93 patients (69%). 2,3,5,8,9,11–16,18,20–22,24–33,36–51,53–55,57–59,61–69 The average total period of observation from the time of initial presentation to the final documented care was 8 years (median 5, range 0.2–70 years), and the average follow-up after last documented treatment was 3 years (median 2, range 0.2–20 years). Follow-up information was available on 87 of 93 (94%) patients.…”