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Mohs micrographic surgery, wide local excision acceptable as first-line treatments for primary BCC

Mohs micrographic surgery or wide local excision with intraoperative margin control were found to be acceptable as first-line treatments for basal cell carcinoma that directly involved the parotid gland, according to researchers.

In a retrospective chart review, the researchers evaluated 19 basal cell carcinoma (BCC) cases involving the parotid gland by direct extension. Of the tumors, nine were primary and 10 were recurrent.

Eight tumors were treated with Mohs micrographic surgery (MMS), and 11 tumors were treated with wide local excision (WLE). One of the patients died due to unrelated causes, and two cases failed to follow-up; therefore, 16 cases remained in the final review. Average length of follow-up in these cases was 55.2 months.

None of the seven primary BCC cases had recurrence after treatment, according to the researchers. Of the 10 nonprimary cases treated, six cases involved subsequent recurrence, two cases developed metastatic disease and one death occurred as a result of metastatic BCC.

Among the six cases that had recurrence, two were treated with MMS and four were treated with WLE with or without parotidectomy.

Due to high rates of future recurrence of BCC involving the parotid gland, adjuvant treatment may also be required in these cases, according to the researchers. - by Kristie L. Kahl

Disclosure: The researchers report no relevant financial disclosures.