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1.
Article in Portuguese | LILACS | ID: biblio-1353076

ABSTRACT

Objetivo: Averiguar a efetividade da utilização da cirurgia de MOHS no manejo de tumores cutâneos tipo não melanoma em comparação a outros métodos de terapia. Métodos: O estudo consiste em uma revisão sistemática, cuja coleta de artigos ocorreu nas bases de dados MEDLINE, PubMed Central (PMC), LILACS e SciELO, utilizando os termos "Cirurgia de MOHS", "Câncer de pele", "Ensaio clínico", excluindo "melanoma". Resultados: Do total de 132 artigos identificados, foram considerados elegíveis 11. A análise dos artigos demonstrou que a CMM, comparada a outros métodos, apresentou resultados estéticos melhores, além de menor grau de complicações em tumores recorrentes e um custo/benefício variável com o país onde foi feita operação. A CMM também apresentou menores índices de recorrência em todos os estudos. Conclusão: No geral, a cirurgia de MOHS se mostrou um método terapêutico promissor. No entanto, existem ainda poucos estudos comparativos sobre a eficácia da CMM e os que existem se concentram em poucas regiões do mundo. (AU)


Objective: Evaluating the effectiveness of using MOHS surgery in the management of non-melanoma skin tumors compared to other therapy methods. Methods: The study consists of a systematic review, whose search for articles was performed using databases MEDLINE, PubMed Central (PMC), LILACS and SciELO, using the terms "MOHS surgery", "Skin cancer", "Clinical trial", excluding "melanoma". Results: from a total of 132 identified articles, 11 were considered eligible. The analysis of the articles showed that MMS, compared to other methods, presented better cosmetic results, in addition to a lower grade of complications in recurrent tumors and a variable cost/benefit according to the country where the surgery was performed. MMS also had lower recurrence rates in all studies. Conclusion:Overall, MOHS surgery has shown promising therapeutic results. However, there are still few comparative studies on the effectiveness of MMS and those that exist are concentrated in a few regions of the world. (AU)


Subject(s)
Humans , Recurrence , Skin Neoplasms , Effectiveness , Mohs Surgery , Costs and Cost Analysis , Melanoma
2.
Oncol. (Guayaquil) ; 29(3): 179-188, 31 de diciembre del 2019.
Article in Spanish | LILACS | ID: biblio-1140784

ABSTRACT

Introducción: El dermatofibrosarcoma protuberans(DFSP), es uno de los tumores cutáneos menos frecuentes, se clasifica dentro de los sarcomas fibrohistociticos y está caracterizado por un crecimiento lento y progresivo. Métodos: Se realizó una serie de casos retrospectiva de los pacientes con DFSP atendidos en el Centro de la Piel (CEPI) entre 2010 y 2019, se tomó en cuenta la información demográfica, características clínicas, tratamiento y su evolución. Resultados: Seis pacientes fueron diagnosticados y tratados por DFSP en el período evaluado, existió un predominio de mujeres (4 mujeres, 2 hombres) con una media de edad de 58.2 (DE =19,6), tres de ellos presentaron lesiones en forma de placa indurada y los restantes presentaron nódulo único, la localización de las lesiones fueron en hombro, cuello e hipogastrio. El tratamiento más utilizado fue la escisión amplia, ninguno de los pacientes presentó recidivas al primer y quinto año del seguimiento. Conclusión: Es necesario el reconocimiento de las características clínicas típicas de DFSP ya que podría pasar como una tumoración benigna de piel, por lo cual se debe apoyar con el estudio histopatológico frente a la sospecha de este tipo de lesión


Introduction: Dermatofibrosarcoma protuberans (DFSP) is one of the rare tumors found in the fibrohistocytic sarcomas and it is characterized by slow and progressive growth. Methods:A retrospective study of six cases treated at the Skin Center (CEPI) between 2010 and 2019 was carried out. We have take into account demographic information, characteristics, treatment and evolution of the lesions. Results:Six patients were diagnosed and treated by DFSP. There was a predominance of women (4 women, 2 men) with a mean age of 58.2 (SD = 19.6), three of them presented lesions in the form of indurated plaque and the rest presented a unique nodule. The locations of the lesions were the shoulder, neck and hypogastrium. The most commonly used treatment was wide excision, none of the patients presented recurrences at the first and fifth year of follow-up. Conclusion:Recognition of the typical clinical characteristics of DFSP is necessary since it could be mistaken as a benign tumor of the skin. The diagnosis must be always done by histopathological confirmation


Subject(s)
Skin , Mohs Surgery , Dermatofibrosarcoma , Histiocytic Sarcoma
3.
An. bras. dermatol ; 94(6): 671-676, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054890

ABSTRACT

Abstract Background: Mohs micrographic surgery is a surgical technique for the treatment of nonmelanoma skin cancer. Surgery begins by removing the visible tumor before excision of the tissue specimens for evaluation of the tumor margins. Objectives: To present a new way to evaluate the material obtained from debulking, by horizontal histological analysis of the fragment. Methods: Descriptive retrospective cross-sectional study based on the medical records and histological lamellae of patients with primary basal cell carcinomas smaller than 1.5 cm submitted to Mohs micrographic surgery and who had the visible tumor analyzed by horizontal histological sections. Results: The sample evaluated included 16 patients with lesions located on the face. Comparing the histopathological examinations of incisional biopsy in vertical sections and debulking in horizontal sections, there was agreement in seven cases. The histological analysis performed in horizontal sections allowed identification of the tumor site in 13 cases, and the relation between tumor and margin showed that in 11 cases, the lateral margin was compromised.Study limitations: The technique was better-applied in lesions smaller than 2 cm. Conclusion: Horizontal histological analysis of debulking has advantages for Mohs surgery, since it allows visualization of almost all tumor extension in the same view plane of the dermatoscopy, allowing better definition of the histological subtype, tumor site, and tumor/margin of lesions less than 1.5 cm.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/surgery , Skin Neoplasms/pathology , Carcinoma, Basal Cell/surgery , Carcinoma, Basal Cell/pathology , Mohs Surgery/methods , Biopsy , Cross-Sectional Studies , Retrospective Studies , Treatment Outcome , Dermoscopy , Tumor Burden
4.
Rev. colomb. cancerol ; 23(3): 99-109, jul.-set. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1042761

ABSTRACT

Resumen El dermatofibrosarcoma protuberans (DFSP) es un sarcoma cutáneo de baja incidencia y lento crecimiento que afecta principalmente a personas de entre 20 a 39 años y es más frecuente en afrodescendientes. La localización anatómica más común es el tronco, seguido de las extremidades superiores. La etiología no está clara, pero la mayoría de los casos presentan rearreglos genéticos que involucran los genes COL1A1 y PDGFB. El riesgo de metástasis es bajo, pero tiene tendencia a la recurrencia local, especialmente en: los tumores resecados con márgenes insuficientes, los tumores profundos y los tumores que presentan cambio fibrosarcomatoso. La primera línea de manejo para la enfermedad local es la cirugía con la resección local amplia o la cirugía micrográfica de Mohs (CMM), que ha mostrado recurrencias consistentemente bajas. La radioterapia se ha usado para tumores irresecables o como adyuvancia. En los casos de enfermedad metastásica el manejo de elección es el imatinib.


Abstract Dermatofibrosarcoma protuberans (DFSP) is a low incidence and slow growing cutaneous sarcoma that mainly affects individuals between 20 and 39 years old and is more frequent in black race. The most common anatomical site is the trunk, followed by the upper extremities. The etiology is unclear, but the most cases present genetic rearrangements involving the COL1A1 and PDGFB genes. The risk of metastasis is low, but it tends to local recurrence, especially when section margins were insufficient, in deep tumors or those with fibrosarcomatous change. The first line of treatment for local disease is surgery; wide local resection or Mohs micrographic surgery (MMS). The latter technique has shown consistently low recurrence rate. Radiotherapy has been used for unresectable cases or as adjuvant therapy. Imatinib is useful for metastatic disease.


Subject(s)
Humans , Mohs Surgery , Dermatofibrosarcoma , Therapeutics
5.
Article in English | WPRIM | ID: wpr-762863

ABSTRACT

BACKGROUND: Merkel cell carcinoma (MCC) is a rare neuroendocrine malignancy affecting the skin, for which timely diagnosis and aggressive treatment are essential. MCC has most often been reported in Caucasians, and case reports in Asians are rare. This study presents our experiences with the surgical treatment and radiotherapy of MCC in Asian patients. METHODS: We retrospectively reviewed the records of seven MCC patients between 2000 and 2018 from a single institution, and analyzed patient characteristics, tumor characteristics, surgical treatment, sentinel lymph node evaluation, reconstruction, adjuvant radiation therapy, and prognosis. RESULTS: Eight MCC lesions occurred in seven patients, most commonly in the head and neck region. All patients underwent surgical excision with reconstruction. The final surgical margin was 1.0 cm in most cases, and reconstruction was most commonly performed with a split-thickness skin graft. Five patients received adjuvant radiotherapy, and two patients received sentinel lymph node biopsy. During the follow-up period, three patients remained well, two died from other causes, one experienced recurrence, and one was lost to follow-up. CONCLUSIONS: We treated seven Asian MCC patients and our series confirmed that MCC is a very dangerous cancer in Asians as well. Based on our experiences, thorough surgical excision of MCC with histopathological clearance should be considered, with sentinel lymph node evaluation if necessary, followed by appropriate reconstruction and careful postoperative observation. Adjuvant radiation therapy is also recommended for all Asian MCC patients. The results of this case series may provide guidance for the treatment of Asian MCC patients in the future.


Subject(s)
Asian Continental Ancestry Group , Carcinoma, Merkel Cell , Diagnosis , Follow-Up Studies , Head , Humans , Lost to Follow-Up , Lymph Nodes , Mohs Surgery , Neck , Prognosis , Radiotherapy , Radiotherapy, Adjuvant , Recurrence , Retrospective Studies , Sentinel Lymph Node Biopsy , Skin , Transplants
6.
Annals of Dermatology ; : 669-672, 2019.
Article in English | WPRIM | ID: wpr-762388

ABSTRACT

Adenoid cystic carcinoma (ACC) is a malignant neoplasm of glands commonly occurs in salivary glands. Primary cutaneous adenoid cystic carcinoma (PCACC) is a rare form of ACC that primarily presents on the skin. Herein, we represent a rare case of PCACC occurred in the umbilicus in a 66-year-old Korean male patient. The patient visited our center with erythematous indurated patch on the umbilicus diagnosed as ACC by incisional biopsy at another center. The diagnosis of PCACC was confirmed by additional histopathologic examination and imaging study. We proceeded Mohs micrographic surgery and reconstructed umbilicus with tacked purse string suture. Local recurrence and distant metastasis were not observed during 30-month follow-up. We report this rare case of PCACC on the umbilicus so that dermatologist can aware of the rare disease. Furthermore, we recommend MMS and tacked purse string suture as effective methods for treatment of PCACC and immediate umbilical reconstruction.


Subject(s)
Adenoids , Aged , Biopsy , Carcinoma, Adenoid Cystic , Diagnosis , Follow-Up Studies , Humans , Male , Mohs Surgery , Neoplasm Metastasis , Rare Diseases , Recurrence , Salivary Glands , Skin , Sutures , Umbilicus
7.
Rev. chil. obstet. ginecol. (En línea) ; 84(2): 130-135, 2019. tab, graf, ilus
Article in Spanish | LILACS | ID: biblio-1013822

ABSTRACT

RESUMEN El dermatofibrosarcoma protuberans (DFSP) es un sarcoma fusocelular de grado intermedio de malignidad con máxima incidencia en adultos entre 20 y 40 años y de localización habitualmente troncular (cabeza, cuello extremidades superiores). Se presentan tres casos de DFSP de localización excepcional a nivel vulvar. Las pacientes fueron tratadas con vulvectomía respetando márgenes de seguridad pero, debido a la idiosincrasia del tumor, presentaron recidivas locales que precisaron de una nueva cirugía. En su posterior seguimiento no presentaron recaídas y se encuentran libres de enfermedad.


ABSTRACT Dermatofibrosarcoma protuberans (DFSP) is an intermediate grade spindle-cell sarcoma with a highest incidence in adults between 20 and 40 years old and a trunk location (head, neck and arms). We introduce three case reports of vulvar DFSP considered unusual because of their location. The patients were conducted a free-margin vulvectomy but, due to the nature of the tumor, local reappearances required a second surgery. In the subsequent follow-up they did not suffer from any tumor relapse and they are currently disease-free.


Subject(s)
Humans , Female , Adult , Middle Aged , Skin Neoplasms/surgery , Skin Neoplasms/diagnosis , Vulvar Neoplasms/surgery , Vulvar Neoplasms/diagnosis , Dermatofibrosarcoma/surgery , Dermatofibrosarcoma/diagnosis , Skin Neoplasms/pathology , Vulvar Neoplasms/pathology , Mohs Surgery , Dermatofibrosarcoma/pathology , Diagnosis, Differential , Vulvectomy
8.
An. bras. dermatol ; 93(5): 719-722, Sept.-Oct. 2018. graf
Article in English | LILACS | ID: biblio-949964

ABSTRACT

Abstract: Advancement flaps are important reconstructive options after skin cancer removal on the nose. Donor areas vary according to defect location and size. The objective of this article is to illustrate the versatility of advancement flaps in nasal reconstruction. Five patients were selected. All cases were treated with Mohs' micrographic surgery prior to reconstruction to ensure that 100% of the surgical margins were free of cancer. Advancement flaps can be used to repair a wide variety of surgical defects on the nose with good matching of skin color, texture, and thickness. With careful planning, resulting scars can be camouflaged in natural boundary lines, leading to good functional and cosmetic outcomes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Skin Neoplasms/surgery , Surgical Flaps , Carcinoma, Basal Cell/surgery , Nose Neoplasms/surgery , Mohs Surgery/methods , Rhinoplasty/methods , Photography , Suture Techniques , Medical Illustration
9.
Oncol. (Guayaquil) ; 28(2): 93-102, Ago. 30, 2018.
Article in Spanish | LILACS | ID: biblio-1000142

ABSTRACT

Introducción: El cáncer de piel es la segunda neoplasia más común en la población guayaquileña, se presenta predominantemente en áreas expuestas a luz solar. Los tipos más frecuentes son el carcinoma basocelular y el escamocelular. La técnica de cirugía micrográfica de Mohs pese a ser descrita hace varias décadas continua vigente en el tratamiento de este tipo de neoplasias. El objetivo del estudio es presentar una serie de casos sometidos a esta cirugía. Métodos: El presente estudio observacional, fue realizado en el Instituto Oncológico Nacional "Dr. Juan Tanca Marengo" Solca-Guayaquil. Se revisaron historias clínicas de los períodos comprendidos de enero del 2015 a diciembre del 2017. Se seleccionaron casos de pacientes con neoplasias malignas de la piel, sometidos a cirugía micrográfica de Mohs. El tipo de muestreo fue no probabilístico de conveniencia. Las variables estudiadas fuero sexo, edad, diagnóstico anatomopatológico, localización de las lesiones y recidivas. Se utiliza estadística descriptiva. Resultados: Se analizaron 153 pacientes con edad media de 71.9 ±12 años, el tipo histológico más frecuente fue el carcinoma basocelular nodular con 115 casos (75.16 %). Las lesiones se localizaron predominantemente en el dorso nasal 40 casos (26.14%) y en el ala nasal 17 casos (11.11%). Al momento de la intervención quirúrgica más de la mitad de las lesiones se encontraban en estadio 1 (58.1%). La técnica de cobertura empleada con mayor frecuencia fue el colgajo de rotación (49 %). No se registraron casos de recidiva posterior a la cirugía micrográfica de Mohs en los pacientes estudiados. Conclusión: Las características epidemiológicas de cáncer de piel en la población de Guayaquil son similares a las reportadas en literatura internacional. Los pacientes sometidos a cirugía micrográfica de Mohs no presentaron recidiva en este reporte.


Introduction: Skin cancer is the second most common neoplasm in the Guayaquil population. It occurs predominantly in areas exposed to sunlight. The most frequent types are basal cell carcinoma and squamous cell carcinoma. The technique of micrographic surgery of Mohs despite being described several decades ago continues in force in the treatment of this type of neoplasms. The aim of the study is to present a series of cases submitted to this surgery. Methods: The present observational study was carried out in the National Oncological Institute "Dr. Juan Tanca Marengo "Solca-Guayaquil. Clinical histories of the periods between January 2015 and December 2017 were reviewed. Cases of patients with malignant neoplasms of the skin were selected, who underwent Mohs micrographic surgery. The type of sampling was non-probabilistic of convenience. The variables studied were sex, age, anatomopathological diagnosis, location of the lesions and recurrences. Descriptive statistics is used. Results: 153 patients with a mean age of 71.9 ± 12 years were analyzed, the most frequent histological type was nodular basal cell carcinoma with 115 cases (75.16%). The lesions were located predominantly on the nasal dorsum, 40 cases (26.14%) and in the nasal ala, 17 cases (11.11%). At the time of surgery, more than half of the lesions were in stage 1 (58.1%). The coverage technique most frequently used was the rotation flap (49%). There were no cases of recurrence after Mohs micrographic surgery in the patients studied. Conclusion: The epidemiological characteristics of skin cancer in the population of Guayaquil are similar to those reported in international literature. Patients undergoing Mohs micrographic surgery did not present recurrence in this report.


Subject(s)
Humans , Skin Neoplasms , Epidemiology , Mohs Surgery , Skin , General Surgery , Neoplasms
10.
An. bras. dermatol ; 93(4): 601-604, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-1038274

ABSTRACT

Abstract: Surgical excision of basal cell carcinoma with minimum margins requires serial assessment of layers by frozen histopathology in the case of Mohs micrographic surgery. Evaluation of presurgical tumor margins by in vivo reflectance confocal microscopy is a potential alternative. We selected 12 basal cell carcinoma lesions that were analyzed by confocal microscopy to define margins. The lesions were excised by Mohs surgery. Six tumors showed negative margins in the first phase of Mohs micrographic surgery. We concluded that reflectance confocal microscopy can be useful in the preoperative definition of basal cell carcinoma margins.


Subject(s)
Humans , Female , Middle Aged , Skin Neoplasms/surgery , Carcinoma, Basal Cell/surgery , Mohs Surgery/methods , Skin Neoplasms/pathology , Carcinoma, Basal Cell/pathology , Microscopy, Confocal , Margins of Excision
11.
Rev. méd. Urug ; 34(3): 177-182, jul. 2018.
Article in Spanish | LILACS | ID: biblio-915035

ABSTRACT

La cirugía micrográfica de Mohs es una técnica que se utiliza para la exéresis de distintos tipos de cánceres de piel que permite el examen histológico del 100% de los márgenes quirúrgicos, con máxima preservación de tejido sano y logrando las más altas tasas de curación. Luego de la realización de la misma existen distintas técnicas para reparar el defecto resultante, una de estas es la cicatrización por segunda intención; consiste en dejar granular la herida de forma espontánea, se puede asistir a esta técnica con apósitos de hidrocoloides para favorecer la cicatrización. Se describe un caso de una paciente añosa con tres defectos grandes faciales, donde se optó por dejar cicatrizar por segunda intención asistido con apósitos hidrocoloidales. (AU)


Mohs surgery is a technique used for the excision of different types of skin cancer which enabled the histological study of the entire (100%) surgical margins, with maximum preservation of healthy tissue and leading to the highest healing rates. After surgery, several techniques are available to repair resulting defects, one of which is healing by second intention. The latter consists in allowing granulation tissue to be formed spontaneously, which can be assisted with hydrocolloid dressings to favor healing. The case of an old age female patient with three facial defects is described. Second intention healing was the choice, assisting it with hydrocolloid dressings. (AU)


A cirurgia micrográfica de Mohs é uma técnica utilizada na exérese de distintos tipos de cânceres de pele, que permite o exame histológico de 100% das margens cirúrgicas, com máxima preservação do tecido saudável conseguindo as taxas mais altas de cura. Depois da realização da mesma existem distintas técnicas para reparar o defeito resultante, sendo uma delas a cicatrização por segunda intenção, que consiste em deixar a ferida granular de forma espontânea; esta técnica pode ser ajudada com curativos hidrocoloides para favorecer a cicatrização. Descreve-se o caso de uma paciente idosa com três defeitos grandes faciais, na qual se optou por deixar cicatrizar por segunda intenção ajudada com curativos hidrocoloides. (AU)


Subject(s)
Wound Healing , Carcinoma, Basal Cell/surgery , Mohs Surgery
12.
Rev. méd. Urug ; 34(1): 29-38, mar. 2018. ilus
Article in Spanish | LILACS | ID: biblio-879954

ABSTRACT

Introducción: la cirugía micrográfica de Mohs es una técnica para la exéresis de cánceres de piel con el examen histológico del 100% de los márgenes quirúrgicos, logrando la tasa de curación más alta con máxima preservación de tejido sano. Objetivo: realizar una descripción clínico-epidemiológica de nuestras primeras 130 cirugías en el Hospital de Clínicas. Método: análisis descriptivo de todos los pacientes operados por un único cirujano de Mohs en nuestra Unidad de Cirugía Dermatológica desde noviembre de 2013 hasta junio de 2016. Se registraron datos clínicos, tumorales y quirúrgicos. Resultados: se estudiaron 130 cirugías en 90 pacientes; 62,3% fueron realizadas en hombres y 37,7% en mujeres. La edad media fue de 68 años (rango: 33-90 años). El 67,7% provenía de Montevideo y el 32,3% del interior del país. El 68% correspondía a carcinoma basocelular y 32% a carcinoma espinocelular. El 91,5% eran tumores primarios y el 8,5% recurrentes. El 75,3% se encontraba en cabeza y cuello. El tipo más frecuente de cierre fueron los colgajos en 43% (56). Hasta el momento, 70 pacientes han completado seguimiento de al menos un año, donde se vio recidiva tumoral en un solo caso (1/70; 1,43%). Conclusiones: la cirugía de Mohs es un procedimiento seguro y eficaz, y nuestros resultados coinciden con lo descrito en centros de referencia internacional. Este es el primer centro de Uruguay que cuenta con un cirujano de Mohs y presentamos el primer estudio en pacientes uruguayos.


Introduction: Mohs micrographic surgery is a technique for the excision of skin cancer with histologic analysis of 100% of the surgical margins, achieving the highest cure rate, while allowing maximum preservation of surrounding healthy tissue. Objective: to perform a clinical-epidemiologic description of our first 130 surgeries at the Hospital de Clínicas. Method: descriptive analysis of all patients operated by a single Mohs surgeon in our Dermatologic Surgery Unit between November 2013 and June 2016. Clinical, tumoral and surgical data was registered. Results: 130 surgeries performed in 90 patients were studied. 62.3% were male patients and 37.7% female. Mean age was 68 years (range: 33 ­ 90 years). 67.7% resided in Montevideo and 32.3% from other parts of the country. 68% corresponded to basal cell carcinoma, and 32% to squamous cell carcinoma. 91.5% were primary tumors, and 8.5% were recurrent. 75.3% were located on the head and neck region. The most frequently used method of closure were flaps in 43% (56). Up to this moment, 70 patients have undergone follow-up for at least twelve months, and so far, only one case showed recurrence (1/70; 1.43%). Conclusions: Mohs surgery is safe and effective, and our results agree with reports of international reference centers. This is the first center in Uruguay with a Mohs Surgeon, and we present the first study in Uruguayan patients.


Introdução: a cirurgia micrográfica de Mohs é uma técnica para a exéreses de cânceres de pele com o exame histológico de 100% das margens cirúrgicas, conseguindo a taxa de cura mais alta com máxima preservação de tecido saudável. Objetivo: realizar uma descrição clínico-epidemiológica das primeiras 130 cirurgias realizadas no Hospital de Clínicas de Uruguai. Método: análise descritiva de todos os pacientes operados por um único cirurgião de Mohs na Unidade de Cirurgia Dermatológica no período novembro 2013 - junho 2016. Foram registrados dados clínicos, tumorais e cirúrgicos. Resultados: foram analisadas 130 cirurgias realizadas em 90 pacientes sendo. 62.3% em homens e 37.7% em mulheres. A média de idade média foi 68 anos (intervalo: 33 - 90 anos). 67.7% eram originários de Montevidéu e os restantes 32.3% do interior. 68% correspondiam a carcinoma basocelular e 32% a carcinoma de células escamosas. 91.5% eram tumores primários e 8.5% recorrentes. 75.3% estavam localizados em cabeça e pescoço. O tipo mais frequente de fechamento foi por retalhos em 43% (56). Até o momento, 70 pacientes completaram um seguimento mínimo de 1 ano, no qual se observou recidiva tumoral em somente 1 caso (1/70; 1.43%). Conclusões: a cirurgia de Mohs é um procedimento seguro e eficaz, e nossos resultados coincidem com os descritos por centros de referência internacional. Este é o primeiro centro no Uruguai que conta com um cirurgião de Mohs e que apresenta o primeiro estudo em pacientes uruguaios.


Subject(s)
Humans , Mohs Surgery , Skin Neoplasms/surgery , Uruguay
13.
Rev. medica electron ; 40(1): 172-182, ene.-feb. 2018. ilus
Article in Spanish | LILACS, CUMED | ID: biblio-902278

ABSTRACT

RESUMEN El carcinoma basocelular es un tumor maligno de origen epitelial, su crecimiento es lento y rara vez metastiza. Este puede producir destrucción local y comprometer extensas áreas de tejido, cartílago y hueso. Existen variantes clínicas e histológicas y constituye el cáncer más frecuente en humanos y su incidencia está en aumento. Se realizó una revisión para exponer los aspectos esenciales sobre factores predisponentes, formas clínicas y diagnóstico, así como las opciones terapéuticas en esta entidad. Se desarrolló una búsqueda en la Biblioteca Virtual de Infomed y Google. Fueron revisados veinticinco trabajos científicos sin limitación de año y país, de los cuales quince pertenecen a los últimos 5 años. El carcinoma basocelular se considera de origen multifactorial, el carcinógeno más importante es la luz ultravioleta. La forma clínica más frecuente es la variedad nodular y la distribución es en cara y cuello. La elección del tratamiento dependerá del tamaño de la lesión, la localización, la edad y estado general del paciente. A pesar de tener baja malignidad y mortalidad, puede ocasionar destrucción y deformidad y repercutir en la vida de los pacientes. El dominio de los factores de riesgo, los elementos para el diagnóstico precoz y las opciones terapéuticas son indispensable para elegir la conducta adecuada frente a la enfermedad y promover cambios en el estilo de vida, que favorezcan la prevención y disminuyan la morbilidad por esta causa (AU).


ABSTRACT Basal cell Carcinoma (BCC) is an epidermal malignant tumor, it has a slow growth and seldom metastases. It can produce local destruction and compromise big tissue areas, cartilage and bone. There are clinical and histological presentations. It is one of the most common cancer in humans and its incidence is increasing. This project’s goal is to expose the essential aspects about the predisposal factors, clinic presentations and diagnoses as well as this disorder’s therapeutic options.This study was made from different bibliographical revisions. The research was developed on Infomed Database and Google. Twenty five Scientific studies were researched without country and/or timeline limit, from whom fifteen belongs to the last 5 years. BCC is considered to have a multifactorial origin, whose most important carcinogen is the ultraviolet light. The most frequent clinical presentation is the nodular and the most common distribution is face and neck. The treatment choice depends on the tumor size, its distribution and the patient’s age and current state. Although it is a low malignancy and low-death rate neoplasia, it can cause tissue destruction and affect patient’s social life. The management of the risk factors, the elements for the early diagnosis and the therapeutic options are indispensable to choose the adequate behavior for the disorder and promote life style changes that favor the prevention and lower the morbidity rate (AU).


Subject(s)
Humans , PUVA Therapy , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/etiology , Carcinoma, Basal Cell/pathology , Carcinoma, Basal Cell/prevention & control , Carcinoma, Basal Cell/therapy , Patient Education as Topic , Risk Factors , Morbidity , Mohs Surgery , Healthy Lifestyle , Microscopy, Polarization , Radiation, Ionizing , Ultraviolet Rays , Causality , Neoplasms, Radiation-Induced
14.
Annals of Dermatology ; : 226-228, 2018.
Article in English | WPRIM | ID: wpr-714153

ABSTRACT

Dermatofibrosarcoma protuberans (DFSP) is a slow growing low-grade cutaneous sarcoma. Local recurrence after excision is common due to the poorly defined periphery that renders histological control of surgical margin difficult, Mohs micrographic surgery is the optimal method for treatment. A 41 years old male patient, who had a previous history of DFSP, came to our dermatology clinic for evaluation of an asymptomatic firm flesh-colored nodule on the forehead. Total excision biopsy was done and the mass was histologically proved as DFSP. Wide excision with reconstruction was performed and showed no sign of recurrence till 18-month follow up. Local recurrence is known to be common for DFSP but a new visible lesion distant from the initial site may be confused as a de novo lesion or a benign neoplasm especially in scalp area, and thus interrupt early detection of DFSP. Herein, we report a case of recurrent DFSP of scalp which recurred distant from the original lesion.


Subject(s)
Biopsy , Dermatofibrosarcoma , Dermatology , Follow-Up Studies , Forehead , Humans , Male , Methods , Mohs Surgery , Recurrence , Sarcoma , Scalp
15.
Article in Korean | WPRIM | ID: wpr-713853

ABSTRACT

Complete removal is most important in treating the malignant tumor from the auricle, but the cosmetic and reconstructive plan after removal should also be considered because auricular appearance contributes enormously to the facial aesthetics. Mohs micrographic surgery (MMS), which is commonly used in dermatology, is considered as minimal marginal surgery that offers superior cure rates in the treatment of facial skin cancer. Therefore, MMS could provide a minimally invasive way to manage the malignant tumor of the auricle. This article reports that basosquamous cell carcinoma arising in the auricle was treated with wide resection combined with MMS. Conclusively, we could accomplish the surgical purpose of both completely removing the tumor and maintaining the auricular aesthetic shape by additionally introducing MMS in the treatment.


Subject(s)
Dermatology , Esthetics , Mohs Surgery , Skin Neoplasms
16.
Article in English | WPRIM | ID: wpr-716793

ABSTRACT

BACKGROUND: Cases of simultaneous multiple skin cancers in a single patient have become more common. Due to the multiplicity of lesions, reconstruction in such cases is more difficult than after a single lesion is removed. This study presents a series of patients with multiple facial skin cancers, with an analysis of the surgical removal, reconstruction process, and the results observed during follow-up. METHODS: We reviewed 12 patients diagnosed with multiple skin cancers on the face between November 2004 and March 2016. The patients’ medical records were retrospectively reviewed to identify the type of skin cancer, the site of onset, methods of surgical removal and reconstruction, complications, and recurrence during follow-up. RESULTS: Nine patients had a single type of cancer occurring as multiple lesions, while three patients had different skin cancer types that occurred together. A total of 30 cancer sites were observed in the 12 patients. The most common cancer site was the nose. Thirteen defects were reconstructed with a flap, while 18 were reconstructed with skin grafting. The only complication was one case of recurrence of basal cell carcinoma. CONCLUSION: Multiple skin cancers are removed by performing Mohs micrographic surgery or wide excision, resulting in multiple defect sites. The authors emphasize the importance of thoroughly evaluating local lesions surrounding the initially-identified lesions or on other sites when reconstructing a large defect which can not be covered by primary closure. Furthermore, satisfactory results can be obtained by using various methods simultaneously regarding the condition of individual patients, the defect site and size, and the surgeon’s preference.


Subject(s)
Carcinoma, Basal Cell , Follow-Up Studies , Humans , Medical Records , Melanoma , Mohs Surgery , Nose , Recurrence , Retrospective Studies , Skin Neoplasms , Skin Transplantation , Skin
17.
Article in Korean | WPRIM | ID: wpr-716119

ABSTRACT

Microcystic adnexal carcinoma (MAC) was first described in 1982 by Goldstein. Considered a rare malignant skin appendageal tumor, it is often underdiagnosed due to its clinical and histopathological resemblance to other cutaneous neoplasms. MAC is locally aggressive with infiltration of perineural spaces, subcutaneous tissue, skeletal muscles, and so on. Aggressive treatment including wide local excision, Mohs micrographic surgery, or radiation therapy is necessary owing to the high recurrence rate. Herein, we report a case of a 47-year-old Korean woman with a skin-colored hardened plaque on the scalp with a clinical diagnosis of cicatricial alopecia and histopathological diagnosis of MAC. After treatment by Mohs micrographic surgery, the patient is being followed up regularly without any sign of recurrence. This case demonstrates an uncommon topography of MAC on the scalp with secondary cicatricial alopecia and highlights the need for awareness of the potential for MAC in the diagnosis of alopecia with a slow-growing tumor.


Subject(s)
Alopecia , Diagnosis , Female , Humans , Middle Aged , Mohs Surgery , Muscle, Skeletal , Pathology , Recurrence , Scalp , Skin , Skin Neoplasms , Subcutaneous Tissue
19.
An. bras. dermatol ; 92(6): 864-866, Nov.-Dec. 2017. graf
Article in English | LILACS | ID: biblio-887108

ABSTRACT

Abstract: Salivary duct injury can be idiopathic, iatrogenic, or post-trauma and may result in sialocele or fistula. Most injuries regress spontaneously and botulinum toxin A is one of several therapeutic possibilities. We report a case of iatrogenic injury to the parotid duct after Mohs' micographic surgery for a squamous cell carcinoma excision in the left jaw region, treated by injection of botulinum toxin type A. Although the fistula by duct injury can be self-limiting, botulinum toxin injection by promoting the inactivity of the salivary gland allows rapid healing of the fistula.


Subject(s)
Humans , Male , Aged , Parotid Gland/injuries , Salivary Gland Fistula/drug therapy , Botulinum Toxins, Type A/administration & dosage , Neuromuscular Agents/administration & dosage , Parotid Gland/surgery , Carcinoma, Squamous Cell/surgery , Mandibular Neoplasms/surgery , Injections, Intralesional , Mohs Surgery/adverse effects , Salivary Gland Fistula/etiology , Treatment Outcome
20.
An. bras. dermatol ; 92(1): 95-99, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-838012

ABSTRACT

Abstract: The majority of penile carcinoma is squamous cell carcinoma. Although uncommon in the United States, it represents a larger proportion of cancers in the underdeveloped world. Invasive squamous cell carcinoma may arise from precursor lesions or de novo , and has been associated with lack of circumcision and HPV infection. Early diagnosis is imperative as lymphatic spread is associated with a poor prognosis. Radical surgical treatment is no longer the mainstay, and penile sparing treatments now are often used, including Mohs micrographic surgery. Therapeutic decisions should be made with regard to the size and location of the tumor, as well as the functional desires of the patient. It is critical for the dermatologist to be familiar with the evaluation, grading/staging, and treatment advances of penile squamous cell carcinoma. Herein, we present a review of the literature regarding penile squamous cell carcinoma, as well as a case report of invasive squamous cell carcinoma treated with Mohs micrographic surgery.


Subject(s)
Humans , Male , Middle Aged , Penile Neoplasms/pathology , Skin Neoplasms/pathology , Carcinoma, Squamous Cell/surgery , Mohs Surgery , Penile Neoplasms/surgery , Skin Neoplasms/surgery , Carcinoma, Squamous Cell/pathology , Treatment Outcome
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