Cutaneous squamous carcinoma in situ (Bowen's disease): Treatment with Mohs micrographic surgery - 21/08/11

Doi : 10.1016/j.jaad.2004.12.033

Igal Leibovitch, MD ^a, Shyamala C. Huilgol, MBBS, FACD ^b, Dinesh Selva, MBBS, FRACS, FRANZCO ^a,^c,^⁎ , Shawn Richards, MBBS, FACD ^d, Robert Paver, MBBS, FACD ^d
^a From the Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences
^b Department of Dermatology, Royal Adelaide Hospital, University of Adelaide
^c Department of Surgery, University of Adelaide
^d Skin and Cancer Foundation Australia, Sydney

Reprint requests: Dinesh Selva, MBBS, FRACS, FRANZCO, Oculoplastic and Orbital Division, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, N Terrace, Adelaide, 5000 South Australia.

Adelaide and Sydney, Australia

Abstract

Background

Bowen's disease (BD), also known as squamous intraepidermal carcinoma, is a malignant skin tumor with a potential to progress to invasive carcinoma.

Objective

We sought to report a large series of patients with BD treated with Mohs micrographic surgery (MMS).

Methods

This prospective, multicenter, case series included all patients in Australia treated with MMS for BD, who were monitored by the Skin and Cancer Foundation between 1993 and 2002.

Results

There were 270 cases; the majority (93.4%) were located in the head and neck area. In 50.7% of cases it was a recurrent tumor. In 20% the tumor was initially misdiagnosed as basal cell carcinoma or squamous cell carcinoma. No cases with perineural invasion were diagnosed. There were 6 cases of recurrence (6.3%) of 95 patients who completed a 5-year follow-up period after MMS.

Conclusion

The low 5-year recurrence rate of BD with MMS emphasizes the importance of margin-controlled excision, especially in the head and neck area where tissue preservation is essential.

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