Appropriate Use criteria for Mohs Micrographic Surgery for Patients and Caregivers: Pt 2

For adnexal carcinomas, this resource compares Mohs micrographic surgery (MMS) with wide-local excision (WLE). MMS removes tissue layer-by-layer with on-the-spot microscopic review, offering precise margin control, low recurrence rates, and typically better cosmetic outcomes; AUC supports MMS for adnexal carcinomas regardless of location. WLE can be effective but may have higher risks of incomplete excision and recurrence, particularly when margins are hard to judge due to infiltrative growth. Limited comparative studies tend to favor MMS for complete removal and outcomes, especially where tissue preservation matters.

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