MICROCYSTIC ADNEXAL CARCINOMA - CASE-REPORT AND REVIEW OF THE LITERATURE

Microcystic adnexal carcinoma is an aggressive, locally destructive cu taneous neoplasm with a high rate of recurrence. This tumor is often m isdiagnosed clinically and histologically. It usually occurs in middle -aged to older adults. We describe a 44-year-old man with a large micr ocystic adnexal carcinoma that was present for more than 20 years. The tumor invaded the perichondrium, muscle, nerve, and blood vessel adve ntitia. A review of the literature suggests that these tumors are ofte n histologically misdiagnosed because the biopsy specimens may be too small to reveal all the characteristic histologic features. The clinic al presence of marked induration, a smooth surface, and, possibly, sen sory changes should alert the clinician to the possibility of this neo plasm. The initial biopsy specimen must be large enough to demonstrate the identifying histologic features. Mohs surgery is currently the tr eatment of choice for microcystic adnexal carcinoma, as it often sprea ds far beyond clinically evident tumor.