scholarly journals Standard Surgical Excision of Basal Cell Carcinomas in the Non-H Area of the Face: A Case Series Illustrating an Alternative to Mohs Micrographic Surgery

2019 ◽  
pp. 1-4
Author(s):  
S Wang ◽  
J Au ◽  
K Ashack ◽  
O Lai ◽  
LS Chan

Introduction: Basal cell carcinoma (BCC) is the most common cutaneous malignancy among Caucasians. Most studies compare the efficacy of standard surgical excision versus Mohs micrographic surgery (MMS) for the treatment of non-melanoma skin cancers in the high-risk or H area of the face. This case series focuses on the lesser-studied non-H area and suggests the use of standard surgical excision as an alternative to MMS for these regions of the face. Methods: A total of 10 patients with BCCs of the non-H area of the face underwent standard surgical excision with repair at the James A. Lovell Federal Health Center between October 2014 to October 2018. The average age of this group was 77.3 years and all patients were males. Nine of the 10 patients had nodular type BCCs and 1 patient had micronodular type BCC with ulceration. BCCs were located on the forehead in 8 cases and the cheek in 2 cases. Diameters of the lesions ranged from 6mm-8mm. Excision margins were 3- to 5-mm. Defects were repaired using local flaps in 9 cases and linear closure in 1 case. Results: Histopathologic evaluation of the excision specimens revealed clear surgical margins in 9 out of 10 cases. There was one case in which positive deep margins were identified, although the patient had a BCC with a more aggressive histologic pattern. Of the 9 cases with clear surgical margins, none had clinical evidence of local recurrence at follow-up ranging from 2 to 38 months. Discussion: BCCs in the non-H area of the face can be successfully treated using standard surgical excision with a high cure rate and low postoperative complications. MMS should be reserved for BCCs at increased risk for recurrence on the basis of factors such as location in the H area on the face and an aggressive histologic growth pattern (e.g. micronodular, morpheaform, infiltrating, metatypical). Practice points: • Basal cell carcinomas in the non-H area of the face can be successfully treated using standard surgical excision with a high cure rate and low postoperative complications. • Mohs micrographic surgery should be reserved for BCCs at increased risk for recurrence on the basis of factors such as location in the H area on the face and an aggressive histologic growth pattern (e.g. micronodular, morpheaform, infiltrating, metatypical).

1997 ◽  
Vol 7 (3) ◽  
pp. 216-222 ◽  
Author(s):  
D. Aliseda ◽  
J. Vazquez ◽  
J.M. Munuera

Objectives. We set out to demonstrate that medial canthus tumors are malignancies requiring microscopically-controlled excision for a high cure rate. We also aim to show that reconstruction can have good esthetic results with a few simple techniques. Methods. During 1992, we treated 38 basal cell carcinomas of the medial canthus, employing our own two-step Mohs’ surgery. All cases were reconstructed with five simple techniques: “laissez faire”, full thickness graft, nasoglabellar flap, mild-line forehead flap or combination of flaps. Results. No recurrent basal cell carcinomas have been observed in our patients during the last four years. All the medial canthus tumours were basal cell carcinomas, eight involving morpheiform infiltration. Perineural infiltration was observed in two cases. Conclusions. Micrographic surgery for medial canthus malignant tumors is the best resection technique. Infiltrating, basal cell carcinomas, are the most common tumors of medial canthus, but also have an excellent cure rate. Reconstruction with a small number of flaps and skin graft is generally an easy process, producing highly satisfactory results.


2013 ◽  
Vol 59 (2) ◽  
pp. 64-70
Author(s):  
Olimpiu Hârceagă ◽  
Corina Baican ◽  
Rodica Cosgarea

Abstract Objective: The aim of this study is to determine the benefits and disadvantages of using micrographic surgery in the treatment of basal cell carcinomas (BCC) of the face. We compared the classic surgery with the micrographic surgery by using a prospective randomized comparative study for two groups of patients. Methods: Patients included in the study were divided into two groups. The first group was treated by Mohs Surgery. A number of 49 patients who presented 52 tumors were included in this group. In the second group were included 52 patients with 53 tumors. These patients were treated by classic surgery. Patients were scheduled for follow-up and evaluation of efficacy of the two surgical methods. Results: The mean follow-up was one year for the micrographic surgery group and 1.1 years for the classic surgery group. For the micrographic surgery group we noted zero recurrences and for the classic surgery group we had two (3.7%) recurrences in two different patients. Treatment time (surgical excision) was 21 minutes for the classic surgery group and 47 minutes for the micrographic surgery group. Conclusions: Micrographic surgery remains the gold standard for the treatment of BCC at the head level. Micrographic surgery is the only treatment method which is reporting healing rates over 95% in the majority of studies. A good selection of the cases is mandatory; micrographic surgery should be used for aggressive tumors in difficult location and especially on the face.


The Lancet ◽  
2004 ◽  
Vol 364 (9447) ◽  
pp. 1766-1772 ◽  
Author(s):  
Nicole WJ Smeets ◽  
Gertruud AM Krekels ◽  
Judith U Ostertag ◽  
Brigitte AB Essers ◽  
Carmen D Dirksen ◽  
...  

2006 ◽  
Vol 142 (2) ◽  
Author(s):  
Brigitte A. B. Essers ◽  
Carmen D. Dirksen ◽  
Fred H. M. Nieman ◽  
Nicole W. J. Smeets ◽  
Gertrude A. M. Krekels ◽  
...  

2014 ◽  
Vol 50 (17) ◽  
pp. 3011-3020 ◽  
Author(s):  
Eva van Loo ◽  
Klara Mosterd ◽  
Gertruud A.M. Krekels ◽  
Marieke H. Roozeboom ◽  
Judith U. Ostertag ◽  
...  

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