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Mohs micrographic surgery effective in treating sebaceous carcinoma

Mohs micrographic surgery was effective in treating patients with sebaceous carcinoma, and should be considered the first-line treatment, according to study results published in Dermatologic Surgery.

Researchers conducted a retrospective review of 37 patients (average age, 66.1 years; 65% men) with sebaceous carcinoma treated with Mohs micrographic surgery (MMS) between 2001 and 2013 in the division of dermatology at Washington University, St. Louis.

There were 45 sebaceous carcinomas, which were located on the periocular region, non-periocular face, scalp, neck, truck and extremities.

Traditional MMS with on-site frozen section interpretation was used to treat 44 of the tumors, while one was treated with modified MMS with permanaent histologic sections.

There were five patients diagnosed with Muir-Torre syndrome or Lynch syndrome.

Immunohistochemical staining was performed on the original biopsy specimen for 12 of the tumors for MLH1, MSH2, MSH6 and PMS2. A loss of expression of at least one mismatch repair gene was shown in seven of the 12 tumors.

Over 3.6 years of follow-up, there were no local recurrences, nodal or distant metastases or disease-specific deaths.

“This is the largest single institution review of sebaceous carcinoma cases treated with MMS,” the researchers concluded. “The incidence of local recurrence and metastasis is rare with MMS and appears to be much lower than historical reported with [wide local excision]. Therefore, MMS should be considered the first-line treatment for removal of sebaceous carcinoma.” – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.