Mohs surgical extirpation of a basal cell carcinoma in a patient with familial multiple trichoepitheliomas.
BACKGROUND
The success of Mohs surgery relies on the ability to histologically differentiate tumor from the normal background tissue of the patient. In most cases of basal cell carcinoma and nonmelanoma skin cancer, this is a relatively straightforward process. However, in distinction, when only subtle histopathologic features differentiate the background tissue from the tumor of interest, the determination of a tumor-free margin becomes more challenging.


OBJECTIVE
Our objective is to highlight the histopathologic features that we used to differentiate our patient's near-confluent background of trichoepitheliomas from the basal cell carcinoma that we were extirpating.


METHODS
Case report.


RESULTS
A 41-year-old white female with a history of familial multiple facial trichoepitheliomas presented for removal of a basal cell carcinoma on her right lower cutaneous lip. Mohs surgery was used to remove the tumor. The characteristic features of basal cell carcinoma and trichoepithelioma were used to differentiate the basal cell carcinoma that we were removing from the surrounding trichoepitheliomatous neoplasia.


CONCLUSIONS
Mohs surgical extirpation of a basal cell carcinoma in a patient with multiple familial trichoepitheliomas requires a clear understanding of the histopathologic features that differentiate a trichoepithelioma from a basal cell carcinoma.
Fisher
Galen H
GH
Laser and Skin Surgery Center of New York, New York, New York 10016, USA.
Mones
Joan
J
Gill
Melissa
M
Celebi
Julide Tok
JT
Geronemus
Roy G
RG
D000328:Adult; D002280:Basal Cell Carcinoma / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D005153:Facial Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015580:Mohs Surgery; D012878:Skin Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps