Pedro Rodríguez-Jiménez, MD, Dermatology Department, Hospital Universitario de la Princesa, Madrid, Calle Diego de Leon 62, 28006 Madrid, Spain;
Acta Dermatovenerol Croat. 2020 Dec;28(7):210-214.
The body of literature supporting the use of Mohs micrographic surgery (MMS) in tumors outside the main indications (basal cell carcinoma, squamous cell carcinoma, dermatofibrosacroma protuberans, lentigo maligna) is constantly growing, but it is still based on case reports, case series, or at best institutional case series that focus on a single malignancy. Our aim in this review was to assess use of MMS in an array of rare tumors outside the usual indications. A review was performed using the MEDLINE database and the search engine ClinicalKey®. We reviewed the use of MMS on atypical fibroxanthoma (AFX)/malignant fibrous histiocytoma, microcystic adnexal carcinoma, extramammary Paget's disease, Merkel cell carcinoma, pocrine/eccrine carcinoma/porocarcinoma, trichilemmal carcinoma, leiomyosarcoma, and angiosarcoma. Mohs micrographic surgery appears to be scarcely used in these tumors due to their low incidence. It is mainly performed for tumors in the H-zone of the face, and can be performed safely. The overall recurrence rate is lower compared with simple or wide local excision. MMS should be used in a more generalized fashion for these tumors.
支持在主要适应证（基底细胞癌、鳞状细胞癌、隆突性皮肤纤维肉瘤、恶性黑色素瘤）之外的肿瘤中使用Mohs 显微外科手术（MMS）的文献不断增加，但这些文献仍基于病例报告、病例系列，或者最多是针对单一恶性肿瘤的机构病例系列。我们在本次综述中的目的是评估 MMS 在一系列罕见肿瘤中的应用，这些肿瘤超出了通常的适应证。我们使用 MEDLINE 数据库和 ClinicalKey®搜索引擎进行了综述。我们回顾了 MMS 在非典型纤维黄色瘤（AFX）/恶性纤维组织细胞瘤、微囊性附属器癌、乳房外 Paget 病、默克尔细胞癌、大汗腺/小汗腺/顶泌汗腺癌、毛发上皮瘤、平滑肌肉瘤和血管肉瘤中的应用。由于这些肿瘤的发病率低，MMS 在这些肿瘤中的应用似乎很少。它主要用于面部 H 区的肿瘤，并且可以安全地进行。与单纯或广泛局部切除相比，总体复发率较低。对于这些肿瘤，应该更广泛地使用 MMS。
