Orbital and Periorbital Microcystic Adnexal Carcinoma

Abstract

Review of the literature shows that microcystic adnexal carcinoma affecting the orbital and periorbital tissues is difficult to differentiate clinically and microscopically from other conditions including squamous cell carcinoma. Eighty-one percent of cases that have histopathology checked in the initial assessment are still misdiagnosed. A high degree of suspicion is necessary if the lesion extends beyond an apparently adequate surgical margin, multiple recurrences occur, or superficial perineural spread is present. Mohs technique is the treatment of choice and may be improved if paraffin sections or immunohistocytochemistry are performed. Wide excision should be carried out once clear margins are obtained. Radiotherapy may be necessary in cases with multiple recurrences.

Microcystic Adnexal Carcinoma: Case Report

“…3 Li te ra tür de or bi ta da bil di ril miş ol gu lar da var dır. 4 Sık lık la 0.5-2 cm ara sın da, sert, sı nır la rı be lir siz, plak ve ya nodül şek lin de dir. Ge nel lik le asemp to ma tik tir.…”

Microcystic Adnexal Carcinoma

“…In the largest published case series, the diagnosis of MAC was made in only 70% of initial biopsy specimens [ 10,16,17 ] . In periocular skin, this fi gure seems to be even lower, applying to only 19% of all 35 periocular MAC reported in the English language literature [ 35 ] . It is possible that this is because smaller biopsies are taken at this site, making a correct diagnosis more challenging.…”

“…20.5 ) [ 20,44 ] . As a consequence, some authors have recommended that the fresh tissue technique is used until tumor margins appear clear on frozen sections and that an additional layer is then sent for paraffi n sections [ 35,45 ] . An alternative to this may be the use of toluidine blue, possibly together with H&E stains on the same tissue blocks [ 37 ] .…”

“…One possible reason for this is frequent failure to make an early correct diagnosis [ 35 ] . In a review study of 35 reported cases with periocular MAC, 5 out of 16 persisted after MMS, and 4 out of 10 after SSE.…”

Periocular Microcystic Adnexal Carcinoma: Management and Outcome with Mohs’ Micrographic Surgery

“…Treatment of periocular MAC with MMS was previously described in only several case reports [15,16,17,18,19]. This prospective study reports in detail 5 patients with periocular MAC treated with MMS who were monitored by the Skin and Cancer Foundation Australia.…”