Rare Cutaneous Soft Tissue Sarcomas Treated With Slow Mohs Micrographic Surgery: Ten Years’ Experience at a Single Institution

Abstract

With the widespread adoption of Mohs micrographic surgery (MMS) for the management of skin cancer, dermatologic surgeons are increasingly being consulted in cases of cutaneous soft tissue sarcoma. Soft tissue sarcoma is a relatively uncommon malignancy of mesenchymal origin1. Although there are limited data in the literature, surgery appears to be the procedure of choice for all patients with localized cutaneous soft tissue sarcomas. The guidelines of the European Society for Medical Oncology recommend excision with a wide surgical margin for primary, low-grade, deep, soft tissue sarcomas ≤5 cm, while surgery with or without adjuvant radiotherapy is suggested for primary, high-grade, deep tumors >5 cm.2 At present, there is no consensus regarding the surgical margin, but the National Comprehensive Cancer Network Soft Tissue Sarcoma Guidelines recommend 1 cm of normal tissue or intact fascia layer3. Although MMS has been suggested to be a useful method for treatment of cutaneous malignant tumors due to its advantages of margin control with preservation of normal tissue, there is a paucity of published data on the optimal surgical margin and outcomes of slow MMS. Here, we describe a variety of cutaneous soft tissue sarcomas diagnosed at a dermatologic surgery unit, and aimed to determine the optimal surgical margin for slow MMS to minimize tumor recurrence.