Indications for mohs micrographic surgery

Abstract

Mohs micrographic surgery (MMS) can be used to treat a wide variety of tumors. General indications for Mohs micrographic surgery require that the cutaneous tumor be continuously growing. Additionally, MMS is considered particularly well suited for tumors that exhibit perineural invasion, tumors in high-risk anatomical areas, tumors that have been incompletely excised, and those with poorly defined clinical margins. The indications for MMS for each tumor type can be divided into common and uncommon entities. The most common indications for MMS include Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC). Less common indications for MMS are not supported by as much evidence, but include: Dermato-fibrosarcoma Protuberans (DFSP), Microcystic Adnexal Carcinoma (MAC), Atypical Fibroxanthoma (AFX), Superficial Leiomyosarcoma, Malignant Fibrous Histiocytoma (MFH), Seba-ceous Carcinoma (SC), Melanoma, Merkel Cell Carcinoma (MCC), and Extramammary Paget's Disease (EMPD). The evidence behind using Mohs micrographic surgery will be discussed for each entity as well as the relevant results from studies used to measure recurrence rates when using Mohs micrographic surgery for these tumors.