Friedman P M, Friedman R H, Jiang S B, Nouri K, Amonette R, Robins P
Department of Dermatology, New York University School of Medicine, New York, 10016, USa.
J Am Acad Dermatol. 1999 Aug;41(2 Pt 1):225-31. doi: 10.1016/s0190-9622(99)70053-8.
Microcystic adnexal carcinoma (MAC) is a malignant appendageal tumor first described in 1982. It can be clinically and histologically confused with other malignant and benign cutaneous neoplasms, leading to inadequate initial treatment. This neoplasm is locally aggressive and deeply infiltrating, characterized by high morbidity and frequent recurrence. Mohs micrographic surgery has been used to conserve tissue and improve the likelihood for cure.
We report our experience using Mohs micrographic surgery for the treatment of MAC and compare with earlier reports in the literature. In addition, we review the epidemiology, clinical and histologic characteristics, and optimal treatment of this rare neoplasm. We also describe a 15-year-old white male patient with MAC on the scalp occurring only 7 years after radiation exposure.
The medical records of 11 patients with MAC who were treated by Mohs micrographic surgery were reviewed at both departments, and follow-up data were obtained.
In all patients treated with Mohs micrographic surgery, there were no recurrences after a mean follow-up of 5 years.
Mohs technique enables the detection of clinically unrecognizable tumor spread and perineural invasion often encountered with MAC. Aggressive initial treatment by microscopically controlled excision appears to offer the greatest likelihood of cure for this neoplasm, while providing conservation of normal tissue. In addition, we describe the second youngest patient with MAC and readdress the issue of previous radiotherapy as an important predisposing factor.
微囊性附属器癌（MAC）是一种1982年首次被描述的恶性附属器肿瘤。它在临床和组织学上可能与其他恶性和良性皮肤肿瘤混淆，导致初始治疗不充分。这种肿瘤具有局部侵袭性且浸润较深，发病率高且复发频繁。莫氏显微外科手术已被用于保留组织并提高治愈的可能性。
我们报告使用莫氏显微外科手术治疗MAC的经验，并与文献中早期的报告进行比较。此外，我们回顾这种罕见肿瘤的流行病学、临床和组织学特征以及最佳治疗方法。我们还描述了一名15岁的白人男性患者，其头皮上的MAC在放疗后仅7年就出现了。
两个科室均回顾了11例接受莫氏显微外科手术治疗的MAC患者的病历，并获得了随访数据。
所有接受莫氏显微外科手术治疗的患者，平均随访5年后均无复发。
莫氏技术能够检测出MAC常见的临床上无法识别的肿瘤扩散和神经周围浸润。通过显微镜控制下的切除进行积极的初始治疗似乎为这种肿瘤提供了最大的治愈可能性，同时保留了正常组织。此外，我们描述了第二年轻的MAC患者，并再次强调既往放疗作为一个重要的诱发因素的问题。
