Surgical outcomes of Adenoid cystic carcinoma treated with Mohs Micrographic Surgery and excision: a systematic review.

Adenoid cystic carcinoma (ACC) is a rare cancer that most commonly occurs in the salivary glands, making up approximately 2-4% of all head and neck malignancies. Treatment for ACC varies, with combinations of surgical excision, adjuvant radiotherapy, and chemotherapy reported in the literature. In this study, we aim to assess ACC recurrence rates with Mohs Micrographic Surgery (MMS) treatment compared to traditional wide local excision (WLE). In June of 2024, a comprehensive review of the literature was performed using the following keywords: "Adenoid Cystic Carcinoma" and/or "Mohs Micrographic Surgery" and/or "MMS" and/or "excision." Between the two databases, 25 articles were identified which included a total of 30 patients. Among all the articles, 30 procedures were documented - 8 MMS and 22 WLE. Patients with ACC treated with WLE had a higher rate of recurrence (40.9%) compared to those treated with MMS (12.5%). Limitations include a small number of tumors treated and reporting bias. MMS for the treatment of ACC demonstrated a decreased recurrence rate compared to WLE. Further studies with larger sample sizes are needed to confirm the benefit of MMS over WLE.