title: Microcystic adnexal carcinoma: treatment with Mohs micrographic surgery.
abstract: BACKGROUND
  Microcystic adnexal carcinoma (MAC) is reported to have a high rate of recurrence with standard wide local excision.
  
  
  OBJECTIVE
  To report a large series of patients with MAC treated with Mohs micrographic surgery (MMS).
  
  
  METHODS
  This prospective, multi-center case series included all patients in Australia treated with MMS for MAC, who were monitored by the Skin and Cancer Foundation between 1993 and 2002.
  
  
  RESULTS
  There were 44 cases; most of them (90.9%) were located in the head and neck area. In 31.8% of cases it was a recurrent tumor. In 32.5% of cases the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. Perineural invasion was recorded in 17.5% of cases; most of them (85.7%) were previously recurrent tumors. There was only one case of recurrence (5%) out of 20 patients who completed a 5 year follow-up period after MMS.
  
  
  CONCLUSIONS
  The low 5-year recurrence rate of MAC with MMS emphasizes the importance of margin-controlled excision.
authors.affiliation: Department of Ophthalmology, Oculoplastic and Orbital Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
authors.forename: Igal
authors.initials: I
authors.lastname: Leibovitch
authors.forename: Shyamala C
authors.initials: SC
authors.lastname: Huilgol
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
authors.forename: Karyn
authors.initials: K
authors.lastname: Lun
authors.forename: Shawn
authors.initials: S
authors.lastname: Richards
authors.forename: Robert
authors.initials: R
authors.lastname: Paver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D002280:Basal Cell Carcinoma / Q000175:diagnosis; D018280:Carcinoma, Skin Appendage / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D002648:Child; D016208:Databases, Factual; D003951:Diagnostic Errors; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D015580:Mohs Surgery / Q000706:statistics & numerical data; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome