Microcystic Adnexal Carcinoma Involving a Large Portion of the Face: When Is Surgery Not Reasonable?

Abstract

Mohs surgery should be the treatment of choice for this tumor; however, when extirpation entails sufficiently large morbidity, given the low rate of metastases and mortality, observation is a reasonable alternative.

Microcystic adnexal carcinoma: A focused review and updates

“…Chemotherapy might be useful in patients with widespread disease who have no other treatment options, but it is not first-line treatment (Eisen, 2005).…”

Microcystic Adnexal Carcinoma

“…These have usually had extensive locoregional disease, and treatment has usually been unsuccessful [ 29 ] . In one patient, the tumor is even thought to have recurred in a more extensive and aggressive form 6 months after primary radiotherapy [ 42 ] .…”

“…In a third study [ 28 ] , there was a history of radiotherapy in 2 out of 13 patients, of whom one was also a renal transplant patient on immunosuppression. In a review [ 29 ] of 274 published cases of MAC, a history of radiation exposure is reported to have preceded development of the tumor in 14 of 84 patients in whom a history was available, an incidence of 19.5%.…”

“…One patient had involvement of the dura mater [ 47 ] , and one had extensive facial infi ltration [ 29 ] .…”

“…In view of the diffi culty of tumor clearance at this site, some authors have suggested that enucleation should be considered in the management of this group of patients [ 35,46 ] . Others disagree given the implications of this procedure [ 9,20,29,47,48 ] .…”