Departments of Dermatology, and.
Pathology, Fundación Universitaria de Ciencias de la salud, Bogotá, Colombia.
Dermatol Surg. 2020 Jun;46(6):753-756. doi: 10.1097/DSS.0000000000002182.
Subclinical extension (SCE) of basal cell carcinomas (BCCs) may be responsible for incomplete resection of the tumor. The aggressive histological patterns (micronodular, infiltrative, and morpheaform) have greater tendencies toward invading surrounding tissues in an irregular pattern.
To determine the SCE of small facial aggressive BCCs excised using Mohs micrographic surgery (MMS).
An observational case series study. Data of patients with facial BCCs with aggressive histological patterns, less than or equal to 6 mm in diameter in high risk site (H zone), and 10 mm in intermediate risk site (M zone), treated with MMS between January 2008 and December 2016, were included.
This study included 306 histologically confirmed lesions retrieved from 1,196 clinical records reviewed. Median size of tumors was 5.7 mm (interquartile range: 5-6 mm). Resection of the tumors using 2, 3, and 4 mm margins achieves complete excision of the lesion including the subclinical extension area in 73.9%, 94.4%, and 99% of cases, respectively.
The present study demonstrated that a 4-mm resection margin was enough to eradicate the lesion completely in 99% of cases of primary small facial BCCs with aggressive histological patterns.
基底细胞癌（BCC）的亚临床扩展（SCE）可能导致肿瘤切除不完全。侵袭性组织学模式（微结节、浸润性和硬皮病样）更倾向于不规则地侵犯周围组织。
确定采用 Mohs 显微外科手术（MMS）切除的小型面部侵袭性 BCC 的 SCE。
观察性病例系列研究。纳入 2008 年 1 月至 2016 年 12 月期间采用 MMS 治疗的高风险部位（H 区）直径小于或等于 6 毫米、中风险部位（M 区）直径小于或等于 10 毫米、具有侵袭性组织学模式的面部 BCC 患者的临床及病理资料。
本研究共纳入 306 个经组织学证实的病变，来源于 1196 例临床记录的回顾。肿瘤的中位大小为 5.7 毫米（四分位距：5-6 毫米）。采用 2、3 和 4 毫米切缘切除肿瘤，分别有 73.9%、94.4%和 99%的病例完全切除了包括亚临床扩展区域的病变。
本研究表明，对于原发性小型面部侵袭性 BCC，采用 4 毫米切缘可在 99%的病例中完全切除病变。
