Mohs surgery for malignant eccrine neoplasms.

BACKGROUND: Eccrine carcinomas (ECs) are rare tumors with potentially aggressive clinical behavior and a high recurrence rate following conventional surgical excision. With the exception of microcystic adnexal carcinoma (MAC), there have been few reports on the use of Mohs micrographic surgery (MMS) as a primary treatment for EC.

OBJECTIVE: To review the use of MMS for EC and compare treatment outcomes with those of conventional surgical excision.

METHODS: We report our use of MMS in 7 cases of EC and review the literature regarding the use of MMS for EC excluding microcystic adnexal carcinoma (MAC), which has been described elsewhere.

RESULTS: A total of 19 case reports describing MMS for non-MAS malignant eccrine neoplasms were reviewed. There were no reported recurrences over an average follow-up period of 29 months, whereas the local recurrence rate following conventional surgical excision of these neoplasms from 10-70%.

CONCLUSIONS: While the clinical experience is limited, the use of MMS appears to decrease recurrence rates when compared to conventional surgical excision. Further experience and longer follow-up intervals will be necessary to demonstrate superior efficacy and recommended surgical margins.