Purpose: To report a series of patients with periocular microcystic adnexal carcinoma (MAC) treated with Mohs’ micrographic surgery (MMS). Design: Prospective, interventional case series. Methods: This series included all patients treated with MMS for periocular MAC, who were monitored by the Skin and Cancer Foundation Australia between 1993 and 2002. Results: There were 5 patients (4 males, 1 female) with a mean age of 52 ± 12 years. Four tumors were located in the medial canthus and one in the lower lid.The tumor was initially misdiagnosed as basal cell carcinoma in 3 patients and squamous cell carcinoma in 1 patient. The average number of excision levels required for complete removal of the tumor during MMS was 2.2 (range 1–6). Perineural invasion was recorded in one patient.Five-year follow-up data was available for 3 patients, and there was no tumor recurrence in any of these cases. Conclusion: The low 5-year recurrence rate of periocular MAC with MMS emphasizes the importance of margin-controlled excision of this tumor.

1.
Goldstein DJ, Barr RJ, Cruz DJ: Microcystic adnexal carcinoma: a distinct clinicopathologic entity. Cancer 1982;50:566–572.
2.
Lipper S, Peiper SC: Sweat gland carcinoma with syringomatous features: a light microscopic and ultrastructural study. Cancer 1979;44:157–163.
3.
Cooper PH, Mills SE: Microcystic adnexal carcinoma. J Am Acad Dermatol 1984;10:908–914.
4.
Cooper PH, Mills SE, Leonard DD, Santa Cruz DJ, Headington JT, Barr RJ, Katz DA: Sclerosing sweat duct (syringomatous) carcinoma. Am J Surg Pathol 1985;9:422–433.
5.
Cooper PH: Sclerosing carcinomas of sweat ducts (microcystic adnexal carcinoma). Arch Dermatol 1986;122:261–264.
6.
Santa Cruz DJ: Sweat gland carcinomas: a comprehensive review. Semin Diagn Pathol 1987;4:38–74.
7.
Requena L, Marquina A, Alegre V, Aliaga A, Sanchez Yus E: Sclerosing (microcystic adnexal) carcinoma: a tumour from a single eccrine origin. Clin Exp Dermatol 1990;15:222–224.
8.
Sebastien TS, Nelson BR, Lowe L, Baker S, Johnson TM: Microcystic adnexal carcinoma. J Am Acad Dermatol 1993;29:840–845.
9.
Salerno S, Terrill P: Will MAC be back? ANJ J Surg 2003;73:830–832.
10.
Burns MK, Chen SP, Goldberg LH: Microcystic adnexal carcinoma: ten cases treated by Mohs’ micrographic surgery. J Dermatol Surg Oncol 1994;20:429–434.
11.
Friedman PM, Friedman RH, Jiang B, Nouri K, Amonette R, Robins P: Microcystic adnexal carcinoma: collaborative series review and update. J Am Acad Dermatol 1999;41:225–231.
12.
Chiller K, Passaro D, Scheuller M, Singer M, McCalmont T, Grekin RC: Microcystic Adnexal carcinoma: Forty eight cases, their treatment and their outcome. Arch Dermatol 2000;136:1355–1359.
13.
Snow S, Madjar DD Jr, Hardy S, Bentz M, Lucarelli MJ, Bechard R, Aughenbaugh W: Microcystic adnexal carcinoma: report of 13 cases and review of the literature. Dermatol Surg 2001;27:401–408.
14.
Abbate M, Zeitouni N, Seyler M, Hicks W, Loree T, Cheney RT: Clinical course, risk factors and treatment of microcystic adnexal carcinoma: a short series report. Dermatol Surg 2003;29:1035–1038.
15.
Hoppenreijs VP, Reuser TT, Mooy CM, de Keizer RJ, Mouritis MP: Syringomatous carcinoma of the eyelid and orbit: a clinical and histopathological challenge. Br J Ophthalmol 1997;81:668–672.
16.
Duffy MT, Harrison W, Sassoon J, Hornblass A: Sclerosing sweat duct carcinoma of the eyelid margin: unusual presentation of a rare tumor. Ophthalmology 1999;106:751–756.
17.
Hesse RJ, Scharfenberg JC, Ratz JL, Grierner E: Eyelid microcystic adnexal carcinoma. Arch Ophthalmol 1995;113;494–496.
18.
Hunts JH, Patel BCK, Langer PD, Anderson RL, Gerwels JW: Microcystic adnexal carcinoma of the eyebrow and eyelid. Arch Ophthalmol 1995;113:1332–1333.
19.
Clement CI, Genge J, O’Donnell BA, Lochhead AG: Orbital and periorbital microcystic adnexal carcinoma. Ophthal Plast Reconstr Surg 2005;21:97–102.
20.
Leibovitch I, Huilgol SC, Selva D, Lun K, Richards S, Paver R: Microcystic adnexal carcinoma: treatment with Mohs’ micrographic surgery. J Am Acad Dermatol 2005;52:295–300.
21.
McAlvany JP, Stonecipher MR, Leshin B, Richard E, White W: Sclerosing sweat duct carcinoma in an 11-year-old boy. J Dermatol Surg Oncol 1994;20:767–768.
22.
Glatt HJ, Proia AD, Tsoy EA, Fetter BF, Klintworth GK, Neuhaus R, Font RL: Malignant syringoma of the eyelid. Ophthalmology 1984;91:987–990.
23.
Ongenae KC, Verhaegh MEJM, Vermeulen AHM, Naeyaert JM: Microcystic adnexal carcinoma: an uncommon tumor with debatable origin. Dermatol surg 2002;27:979–984.
24.
Wick MR, Cooper PH, Swanson PE, Kaye VN, Sun TT: Microcystic adnexal carcinoma: an immunohistochemical comparison with other cutaneous appendage tumors. Arch Dermatol 1990;126:189–194.
25.
Leboit PE, Sexton M: Microcystic adnexal carcinoma of the skin. J Am Acad Dermatol 1993;29:609–618.
26.
Mayer MH, Winton GB, Smith AC, Lupton GP, Parry EL, Shagets FW: Microcystic adnexal carcinoma (sclerosing sweat duct carcinoma). Plast Reconstr Surg 1989;84:970–975.
27.
Rapini RP: Comparison of methods for checking surgical margins. J Am Acad Dermatol 1990;23:288–294.
28.
Feasel AM, Brown TJ, Bogle MA, Tschen JA, Nelson BR: Perineural invasion of cutaneous malignancies. Dermatol Surg 2001;27:531–542.
29.
Mendenhall WM, Amdur RJ, Williams LS, Mancuso AA, Stringer SP, Mendenhall NP: Carcinoma of the skin of the head and neck with perineural invasion. Head Neck 2002;24:78–83.
30.
McCord MW, Mendenhall WM, Parsons JT, Amdur RJ, Stringer SP, Cassisi NJ, Million RR: Skin cancer of the head and neck with clinical perineural invasion. Int J Radiat Oncol Biol Phys 2000;47:89–93.
31.
Matorin PA, Wagner RF Jr: Mohs’ micrographic surgery: technical difficulties posed by perineural invasion. Inter J Dermatol 2002;31:83–86.
32.
Marshall J, Mortimore R, Sullivan T: Sclerosing sweat duct carcinoma of the orbit. Orbit 2003;22:165–170.
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