Dermatology & Plastic Surgery Institute Outcomes
Dermatologic Surgery and Cutaneous Oncology
Primary mucinous carcinoma of the skin (PMCS) is a rare sweat gland tumor with just over 200 cases in the literature. ¹ ² Although uncommonly metastatic, it does have a propensity for local recurrence, and thus, Mohs Micrographic Surgery (MMS) and wide local excision (WLE) are the preferred treatments. When metastasis does occur it is most commonly in regional lymph nodes. All cases of PMCS should have a workup to exclude visceral primary tumors.
Clinicians in the Institute of Dermatology and Plastic Surgery reported 14 cases of PMCS seen at Cleveland Clinic from 1990 through May 2020. In each case, the histologic diagnosis had been made and/or confirmed by a dermatopathologist based on hematoxylin & eosin-stained biopsy specimens and immunohistochemical stains when necessary. Ten patients were treated with MMS, 3 with wide local excision WLE, and 1 with excisional biopsy. Follow-up was based on clinic notes following initial treatment.
Eleven of the patients were alive with no evidence of disease at the time of the inquiry, and 2 patients were deceased from natural causes. One patient who underwent multiple excisions elsewhere died from metastatic mucinous carcinoma. The mean follow- up was 33.6 months (range, 0.5-221 months). The recurrence rate in the literature following MMS is 7%-13% and WLE is 34%.
Clinical Summary of Cases
|Case||Sex||Race||Age at Diagnosis (years)||Location||Treatment||Follow-up (months)||Recurrence||Current Status|
|1||F||White||83||Scalp||WLE x 5||Unclear||Multiple||Deceased (Metastatic disease)|
|3||F||White||56||Eyebrow||MMS x 2||42||Yes after MMS||Alive, NED|
|4||M||Black||75||Upper eyelid||MMS||48||None||Alive , NED|
|5||F||White||60||Lower eyelid||MMS||5||None||Alive, NED|
|6||M||White||76||Lower eyelid||MMS||0.5||None||Alive, NED|
|7||M||White||62||Lower eyelid||MMS||2||None||Alive, NED|
|10||F||White||57||Lower eyelid||MMS||2||None||Alive, NED|
|12||M||White||45||Upper eyelid||MMS||1||None||Alive, NED|
MMS = Mohs Micrographic Surgery, NED = no evidence of disease, WLE = Wide local excision