Primary Cutaneous Mucinous Carcinoma Treated with Narrow Surgical Margin

Abstract

Primary cutaneous mucinous carcinoma (PCMC) is a rare malignant tumor of eccrine origin. Clinically, the carcinoma presents as a solitary, slow growing, and painless nodule. For this reason, this tumor is often considered to be a benign mass in the preoperative setting. The lesion is, however, malignant in nature and has a tendency for local recurrence and infrequent metastasis. Wide local excision is the treatment of choice. However, few reports exist with information regarding surgical margins and clinical outcomes. Herein, we report a case of PCMC excised with a narrow surgical margin and review the relevant literature. A 49-year-old man presented with a small cutaneous nodule of the right cheek. The mass was excised without any margin, but pathologic examination revealed histology of mucinous carcinoma. Because of this, the operative site was re-excised with a 5-mm margin, and the wound was closed using a V-Y advancement flap. Systemic work-up did not reveal other potential metastatic primary, for a final diagnosis of PCMC. We report this case of PCMC, treated with relatively narrow margin in a patient with good prognostic factors.

Importance of Early Detection and Complete Resection of Primary Cutaneous Mucinous Carcinoma with Lymphatic Metastasis: A Case Report and Literature Review

“…In cases with a favorable prognosis, a 5-10 mm surgical margin is recommended 10) . However, there are very few reports on the resection area in large tumor diameter or trunk incidence cases.…”

Primary Cutaneous Mucinous Carcinoma of the Eyelid: A Case Report

“…For recurrent cases and sites such as the eyelid, Moh's micrographic surgery is preferred as this allows for the complete removal of the tumor along with margins and preserves tissue, bronchi, renal pelvis, and ovary (6). It is also important to differentiate metastatic mucinous adenocarcinoma (1,3,8); this can be done via a thorough clinical and imaging assessment (4). Primary cutaneous mucinous carcinoma is CK-7 positive and CK-20 negative, unlike metastases of the gastrointestinal tract, which are CK-20 positive and CK-7 negative.…”

Primary Cutaneous Mucinous Carcinoma: A Review of the Literature

“…Although these data suggest that MMS may be associated with a lower recurrence rate, the small number of cases and limited follow-up time necessitates continued monitoring of these patients. Choi and colleagues 58 have also suggested the potential for margin selection based on prognostic factors in areas where tissue-sparing is appropriate; however, they did not report follow-up data on their cases. Traditional surgical excision was associated with poorer outcomes, as defined by recurrence and metastasis, in a meta-analysis by Kamalpour and colleagues 2 as compared with MMS.…”