Type of Surgery
Information
Last updated: 11/24/2009
Mohs surgery is used to treat such cancers of the skin as basal cell carcinoma, squamous cell carcinoma, and melanoma.
Malignant skin tumors may occur in strange, asymmetrical shapes. The tumor may have long finger-like projections that extend...
across the skin (laterally) or down into the skin. Because these extensions may be composed of only a few cells, they cannot be seen or felt. Standard surgical removal (excision) may miss these cancerous cells leading to recurrence of the tumor. To assure removal of all cancerous tissue, a large piece of skin needs to be removed. This causes a cosmetically unacceptable result, especially if the cancer is located on the face. Mohs surgery enables the surgeon to precisely excise the entire tumor without removing excessive amounts of the surrounding healthy tissue.
Mohs surgery is performed when:
- The cancer was treated previously and recurred.
- Scar tissue exists in the area of the cancer.
- The cancer is in at least one area where it is important to preserve healthy tissue for maximum functional and cosmetic result, such as on the eyelids, the nose, the ears, and the lips.
- The edges of the cancer cannot be clearly defined.
- The cancer grows rapidly or uncontrollably.
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Other Information
Mohs surgery, also known as "Chemosurgery", was created by a general surgeon, Dr. Fredrick E. Mohs, is microscopically controlled surgery that is highly effective for common types of skin cancer, with a cure rate cited between 97% and 99% for primary basal cell carcinoma, the most common type of skin cancer, and for squamous cell carcinoma. Recurrent basal cell cancer has a lower cure rate with Mohs surgery, more in the range of 94% It has been used in the removal of melanoma-in-situ (cure rate 77%), and certain types of melanoma (cure rate 52%). Other indications for Mohs surgery include dermatofibrosarcoma protuberans, keratoacanthoma' spindle cell tumors, sebaceous carcinomas, microcystic adnexal carcinoma, merkel cell carcinoma, Pagets's disease of the breast, atypical fibroxanthoma, leimyosarcoma, and angiosarcoma. Because the Mohs procedure is micrographically controlled, it provides precise removal of the cancerous tissue, while healthy tissue is spared. Mohs surgery is relatively expensive when compared to other surgical modalities. However, in anatomically important areas (eyelid, nose, lips), tissue sparing and low recurrence rate makes it a procedure of choice by many physicians.
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