A Study of Tissue Invasion of Basal Cell Carcinoma by Mohs Micrographic Surgery

Song, Ki Hoon; Kim, Ki Ho; Joh, Gwang Yeol

Abstract

BACKGROUND: Mohs micrographic surgery is an ideal method for removing the BCC completely. Several studies defining proper lateral margin for excision of BCC have been reported. However, the study of invasion depth of BCC has not been specially addressed.
OBJECTIVE
In our study, we evaluated the safety lateral margin as well as depth of excision of BCC and the correlation with the histopathological aspects by using Mohs micrographic surgery technique.
METHODS
Fourty nine patients with BCCs(29 primary, 20 recurrent) diagnosed in the Department of Dermatology of Dong-A University Hospital from March, 1991 through February, 1997 were studied prospectively. RESUTLS: 1. Fifty five percent of tumors in our series had 2mm maxumal margins and 70% of recurrent BCC were eradicated with 4-mm more lateral margins. 2. Sixty two percent of BCC located in the cheek was eradicated with the excision within the mid-subcutaneous fat and more than 76% of the tumor in the nose required the removal of the periosteum or perichondrium. 3. In Ninety five percent of BCC, less than 14mm required a 4mm lateral margin and only 5% required a 6mm margin. However, seventy two percent of BCC was eradicated with a 4mm lateral margin and more than 36% was eradicated with a 6-mm or more lateral margin. 4. Eight percent of the micronodular type required 4mm or more lateral margins and had a tendency to invade more deeply. All nodular micronodular-infiltrative BCC had 4mm or more maximal subclinical extension and periosteum/perichondrial or deeper vertical invasion.
CONCLUSION
Mohs micrographic surgery is an appropriate tool to use in proposing guidelines for treatment for BCC and clinicopathological characteristics of BCC such as anatomic location, tumor size, histopathological subtype may be helpful to plan the proper surgical margins.