Periocular microcystic adnexal carcinoma: Management and outcome with Mohs' micrographic surgery

Purpose: To report a series of patients with periocular microcystic adnexal carcinoma (MAC) treated with Mohs' micrographic surgery (MMS). Design: Prospective, interventional case series. Methods: This series included all patients treated with MMS for periocular MAC, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. Results: There were 5 patients (4 males, 1 female) with a mean age of 52 ± 12 years. Four tumors were located in the medial canthus and one in the lower lid. The tumor was initially misdiagnosed as basal cell carcinoma in 3 patients and squamous cell carcinoma in 1 patient. The average number of excision levels required for complete removal of the tumor during MMS was 2.2 (range 1-6). Perineural invasion was recorded in one patient. Five-year follow-up data was available for 3 patients, and there was no tumor recurrence in any of these cases. Conclusion: The low 5-year recurrence rate of periocular MAC with MMS emphasizes the importance of margin-controlled excision of this tumor.