Microcystic adnexal carcinoma: report of four cases treated with Mohs' micrographic surgical technique

Background Microcystic adnexal carcinoma (MAC) is a rare and aggressive malignant tumor of the sweat glands. Clinically, it often presents as a firm subcutaneous nodule on the head and neck regions. On histology, MAC exhibits both pilar and sweat duct differentiation with a stroma of dense collagen. It often extends beyond the clinical margins with local spreading in the dermal, subcutaneous, and perineural tissue planes. It has a high local recurrence rate after standard excision. Recent preliminary reports have indicated more favorable cure rates with Mohs’ micrographic surgery (MMS). Objective To present our data on four cases of MAC treated by MMS. We also compared our findings with more recently reported series in the English language literature. Methods We reviewed the medical records of four patients (two males and two females) with MAC treated by MMS over the last 3 years. We also obtained follow‐up data. Results In all four patients with MAC treated by MMS, there were no recurrences, with a mean follow‐up of 1 year. Conclusion We report an additional four MAC cases treated by MMS. The accumulated data continue to confirm that, if the diagnosis of MAC is made early, and if the anatomic location is accessible to excision by MMS, a favorable outcome can be expected.