The use of Mohs micrographic surgery for determination of residual tumor in incompletely excised basal cell carcinoma.

Abstract

The presence of tumor involving surgical margins after excision of basal cell carcinoma (BCC) presents a therapeutic dilemma. Some authors advocate a conservative policy whereas others recommend immediate reexcision. Our purpose was to evaluate residual tumor utilizing Mohs micrographic surgery (MMS) of those BCCs with margin involvement after primary excision. We retrospectively reviewed 77 patients with 78 tumors who underwent MMS because of margin involvement after primary excision of BCC to detect the presence or absence of residual tumor. Residual tumor was found in 55% of the cases as defined by the need for two or more stages of MMS to achieve a tumor-free plane. We suggest reexcision of all BCCs that are found to have marginal involvement after primary excision because of the large percentage of cases found to have residual tumor.