Cylindrocarcinoma: Could Mohs Surgery Be the Clear-Cut Winner?
Cylindrocarcinoma—a rare malignant offshoot of benign cylindromas—poses a surgical challenge due to its potential for recurrence and metastasis. While traditional excision has been the standard, new research suggests Mohs micrographic surgery (MMS) might offer superior outcomes.
In a systematic review of 12 patients and 18 procedures, MMS emerged with a notably lower recurrence rate than standard excision. Most patients treated with MMS remained recurrence-free, while just under half of those who underwent traditional excision saw no return of disease. The lone MMS case that did recur may have involved a separate tumor entirely, hinting at the possibility of multifocal malignancy rather than incomplete removal.
Though limited by the rarity of the condition and gaps in reported surgical data, the findings point toward MMS as a potentially more effective option for achieving clear margins and reducing recurrence. For dermatologists treating cylindrocarcinoma—particularly in patients with Brooke-Spiegler Syndrome or familial cylindromatosis—this could signal a shift in best practices.
J Drugs Dermatol. 2025;24(5). doi:10.36849/JDD.8779
