Mohs micrographic surgery for cutaneous malignancies: A focus review of its indications in pediatric age groups

Abstract

Mohs micrographic surgery (MMS) is a highly specialized technique that has been successful in the treatment of a variety of skin tumors. The technique can be performed as an outpatient procedure and encompasses surgical excision and intraoperative assessment of tumor margins in one setting by the same physician. The process ensures precise margin control with maximal preservation of healthy tissues. Mohs micrographic surgery has been practiced worldwide, including in the United States, Europe (United Kingdom, Germany, Spain, Netherlands, Switzerland), and Australia. Although it is commonly performed in adults with greater success, it has been discussed less frequently in children. In this article, we describe several cutaneous tumors in children and the role of Mohs micrographic surgery in their management. A PubMed search was conducted to review the most common cutaneous tumors in children treated using Mohs micrographic surgery. In this review, we discuss indications for Mohs micrographic surgery and pertinent studies examining success rates in children. Mohs micrographic surgery has been used to treat several tumors in children and offers the advantage of high cure rates and tissue conservation. This report emphasizes the benefits of Mohs micrographic surgery in children and highlights several cutaneous tumors for which it has been used to treat successfully.

AXIN2 and SNAIL expression predict the risk of recurrence in cutaneous squamous cell carcinoma after Mohs micrographic surgery

“…The average annual percentage change (AAPC) of cSCC has increased both in women [AAPC, 6.8 (95% CI, 5.3 to 8.4)] and men [AAPC, 3.3 (95% CI, 2.6 to 4.0)] (1,2). Surgical treatment is curative in most cases of cSCC; in particular, Mohs micrographic surgery (MMS) has become an common treatment option for various types of cutaneous neoplasm, including cSCC (3). As a standard form of tissue-conservative skin cancer surgery, MMS ensures clearance of pathological margins via intraoperative histopathologic interpretation using the fresh-frozen tissue technique; therefore, MMS leads to a lower recurrence rate compared with other therapies that use conventional wide excision (3).…”

“…Surgical treatment is curative in most cases of cSCC; in particular, Mohs micrographic surgery (MMS) has become an common treatment option for various types of cutaneous neoplasm, including cSCC (3). As a standard form of tissue-conservative skin cancer surgery, MMS ensures clearance of pathological margins via intraoperative histopathologic interpretation using the fresh-frozen tissue technique; therefore, MMS leads to a lower recurrence rate compared with other therapies that use conventional wide excision (3). However, certain patients that experience recurrence following MMS require adjuvant therapy (3)(4)(5).…”

“…As a standard form of tissue-conservative skin cancer surgery, MMS ensures clearance of pathological margins via intraoperative histopathologic interpretation using the fresh-frozen tissue technique; therefore, MMS leads to a lower recurrence rate compared with other therapies that use conventional wide excision (3). However, certain patients that experience recurrence following MMS require adjuvant therapy (3)(4)(5). Since adjuvant therapy can cause numerous side effects, it is crucial to identify a reliable method for assessing the risk of recurrence in patients with cSCC following surgery.…”