MOHS MICROGRAPHIC SURGERY OF UNCOMMON TUMORS (ANGIOSARCOMA, ECCRINE, PAGET, AND MERKEL CELL)

Course overview

MOHS MICROGRAPHIC SURGERY (MMS) IS WIDELY USED TO TREAT COMMON CUTANEOUS MALIGNANCIES SUCH AS SQUAMOUS AND BASAL CELL CARCINOMAS. DUE TO ITS HIGH CURE RATES AND TISSUE PRESERVATION, MMS IS WARRANTED AS AN ALTERNATIVE FOR TREATING RARE TUMORS. IN RECENT YEARS, SEVERAL INTERNATIONAL RESEARCH GROUPS HAVE STUDIED AND REPORTED ON THE EFFICACY AND OUTCOMES OF MMS IN TREATING UNCOMMON CUTANEOUS MALIGNANCIES (UCMS), SUCH AS ANGIOSARCOMA, MERKEL CELL CARCINOMA, ECCRINE MALIGNANT TUMORS, AND PAGET DISEASE. ALTHOUGH UCMS GENERALLY HAVE POORER PROGNOSES COMPARED TO COMMON CUTANEOUS MALIGNANCIES, MMS SHOWS PROMISE FOR THEIR TREATMENT. MANY UCMS LACK DISTINCTIVE CLINICAL FEATURES, MAKING EARLY DIAGNOSIS CHALLENGING WHEN BASED SOLELY ON CLINICAL CHARACTERISTICS. TYPICALLY, UCMS ARE TREATED WITH WIDE LOCAL EXCISIONS, BUT MMS HAS BEEN INCREASINGLY USED AS AN ALTERNATIVE, SUPPORTED BY CASE REPORTS AND SERIES DEMONSTRATING ITS BENEFITS. HOWEVER, THE USE OF MMS IS DEBATED DUE TO THE HIGH METASTATIC POTENTIAL OF SOME TUMORS, SUCH AS ANGIOSARCOMA AND MERKEL CELL CARCINOMA. THIS ACTIVITY EXPLORES THE ROLE OF MMS IN UCM TREATMENT, DISCUSSING THE EPIDEMIOLOGY, ETIOLOGY, CLINICAL PRESENTATION, AND HISTOLOGICAL FINDINGS OF VARIOUS UCMS, WHERE MMS HAS SHOWN INCREASING RELEVANCE IN RECENT LITERATURE. ADDITIONALLY, THIS ACTIVITY HIGHLIGHTS THE ADVANTAGES AND DISADVANTAGES OF USING MMS AS AN ALTERNATIVE TREATMENT FOR THE ABOVE-MENTIONED UCMS. THIS ACTIVITY PROVIDES INTERPROFESSIONAL HEALTHCARE PROVIDERS WITH THE KNOWLEDGE AND TOOLS TO ENHANCE DECISION-MAKING WHEN EVALUATING TREATMENT OPTIONS FOR PATIENTS WITH UCMS, ENSURING THE HIGHEST STANDARD OF CARE FOR AFFECTED PATIENTS.