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Vol. 99. Issue 4.
Pages 275-280 (May 2008)
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Vol. 99. Issue 4.
Pages 275-280 (May 2008)
Original articles
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Mohs Micrographic Surgery: Our First 100 Patients
Cirugía de Mohs: Nuestros Primeros Cien Pacientes
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T. Alonso
Corresponding author
teresa@aedv.es

Correspondence: Servicio de Dermatología. Hospital de León, C/ Altos de Nava, s/n, 24280 León, Spain.
, P. Sánchez, A. González, J. Ingelmo, I. Ruiz, S. Delgado, M.A. Rodríguez
Servicio de Dermatología, Hospital de León, León, Spain
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Abstract
Introduction

Mohs surgery was first described by Frederic Mohs in 1941 to eliminate high-risk cutaneous tumors. The technique involves histological examination of the margins.

Objective

The aim of this study was to describe the clinical findings and compare the grade and subclinical extension of the tumor—as measured by the number of Mohs stages needed for complete elimination—according to whether the tumor presented high-risk factors.

Methods

We included 100 patients with 105 tumors. In all cases, age, sex, tumor site, tumor type, histological subtype in the case of basal cell carcinoma, size, recurrences, number of Mohs stages, and reconstruction technique were recorded.

Results

The study group comprised 44 men and 56 women aged between 28 and 88 years (mean, 72.6 years). Of the tumors, 80% corresponded to basal cell carcinoma, 12.38% to squamous cell carcinoma, 4.76% to dermatofibrosarcoma protuberans, 0.95% to Merkel cell carcinoma, 0.95% to microcystic adnexal carcinoma, and 0.95% to lentigo maligna melanoma. Most tumors were located on the head and 60% required more than one Mohs stage for complete elimination.

Conclusion

This series is characterized by a high percentage of high-risk cutaneous tumors. After assessing the risk factors independently, we found that the size of the tumor is the risk factor most closely related to grade and subclinical extension in the case of basal cell carcinoma, although similar conclusions cannot be drawn for the other types of tumor studied.

Key words:
Mohs surgery
cutaneous tumors
surgery
treatment
Resumen
Definición

Descrita por Frederic Mohs en 1941, la cirugía de Mohs es una técnica quirúrgica con control histológico de los bordes, utilizada para eliminar tumores cutáneos de alto riesgo.

Objetivo

El objetivo de este artículo es informar de los hallazgos clínicos y comparar la agresividad-extensión subclínica del tumor, medida como número de estadios de Mohs necesarios para eliminar completamente el tumor, en función de que el tumor presente o no factores de alto riesgo.

Métodos

Se incluyen 100 pacientes con 105 tumores y en todos los casos se obtuvieron las variables de edad y sexo del paciente, localización, tipo de tumor y subtipo histológico en el caso del carcinoma basocelular, tamaño, existencia de recurrencias, número de estadios de Mohs y técnica de reconstrucción.

Resultados

Se incluyen 44 hombres y 56 mujeres de edades comprendidas entre los 28 y 88 años (media 72,6). El 80% eran carcinomas basocelulares, el 12,38% carcinomas espinocelulares, el 4,76% dermatofibrosarcomas protuberans, el 0,95% carcinoma de células de Merkel, el 0,9 5% carcinoma anexial microquístico y el 0,95% lentigo maligno melanoma. La mayoría estaban localizados en la cabeza y el 60% precisó más de un estadio de Mohs para ser eliminado.

Conclusión

Esta serie se caracteriza por presentar un alto porcentaje de tumores cutáneos de alto riesgo. Valorando estos factores de riesgo de forma independiente podemos concluir que el tamaño del tumor es el factor de riesgo que más se relaciona con la agresividad y la extensión subclínica en el caso del carcinoma basocelular, no pudiendo llegar a conclusiones similares para el resto de los tumores incluidos en este trabajo.

Palabras clave:
cirugía de Mohs
tumores cutáneos
cirugía
tratamiento
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Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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