Micrographic Surgery of Basal Cell Carcinomas of the Head

  • Birgit Woerle
  • Marc Heckmann
  • Birger Konz
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 160)


Basal cell carcinoma (BCC) is a locally invasive malignant cutaneous tumour with a rising incidence. This tumour can be treated successfully by a variety of techniques, including local excision, radiation, cryotherapy, curettage, electrodessication and laser obliteration. Micrographic surgery is a specialised type of minimal marginal surgery that offers higher cure rates than do other options in the treatment of contiguous skin cancers in selected settings. The horizontal frozen histological sections of the excised tumour permit complete microscopic examination of the surgical margin. Maximum sparing of tumour-free adjacent tissue is achieved with histological mapping of the tumour boundaries, and subsequent wound reconstruction is optimised. Data on topographical distribution, histopathological subtype, subclinical tumour extension, therapeutic procedures required for complete eradication, and recurrence rates were recorded in 3065 BCC of the head. Micrographic surgery is the treatment of choice for large or invasive primary BCC with uncertain clinical boundaries, especially in difficult anatomical regions, for recurrent or re-recurrent BCC, and for tumours with an aggressive histopathological pattern.


Basal Cell Carcinoma Histopathological Subtype Tumour Boundary Complete Tumour Removal Mohs Micrographic Surgery 


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  1. Breuninger H, Dietz K (1991) Prediction of subclinical tumor infiltration in basal cell carcinoma. J Dermatol Surg Oncol 17:574–578.PubMedGoogle Scholar
  2. Breuninger H, Schippert W, Black B, Rassner G (1989) Untersuchungen zum Sicherheitsabstand und zur Exzisionstiefe in der operativen Behandlung von Basaliomen. Hautarzt 40:693–700.PubMedGoogle Scholar
  3. Brodland DG, Amonette R, Hanke W, Robins P (2000) The history and evolution of Mohs micrographic surgery. Dermatol Surg 26:303–307.PubMedCrossRefGoogle Scholar
  4. Dobke MK, Miller SH (1997) Tissue repair after Mohs surgery. A plastic surgeon’s view. Dermatol Surg 23:1061–1066.Google Scholar
  5. Hruza GJ (1994) Mohs micrographic surgery local recurrences. J Dermatol Surg Oncol 20:573–577.PubMedGoogle Scholar
  6. Konz B (1975) Use of skin flaps in dermatologic surgery of the face. J Dermatol Surg 3:25–30.Google Scholar
  7. Kopke LFF, Konz B (1995) Mikrographische Chirugie. Eine methodische Bestandsaufnahme. Hautarzt 46:607–614.CrossRefGoogle Scholar
  8. Lawrence CM (1999) Mohs’ micrographic surgery for basal cell carcinoma. Clin Exp Dermatol 24:130–133.PubMedCrossRefGoogle Scholar
  9. Lo JS, Snow SN, Reizner GT, Mohs FE, Larson PO, Hruza GJ (1991) Metastatic basal cell carcinoma: report of twelve cases with a review of the literature. J Am Acad Dermatol 24:715–719.PubMedCrossRefGoogle Scholar
  10. Mohs FE (1941) Chemosurgery: a microscopically controlled method of cancer excision. Arch Surg 42:279–295.Google Scholar
  11. Shriner DL, McCoy DK, Goldberg DJ, Wagner RF (1998) Mohs micrographic surgery. J Am Acad Dermatol 39:79–97.PubMedCrossRefGoogle Scholar
  12. Thissen MRTM, Neumann MHA, Schouten LJ (1999) A systematic review of treatment modalities for primary basal cell carcinomas. Arch Dermatol 135:1177–1183.PubMedCrossRefGoogle Scholar
  13. Wennberg A-M (2000) Basal cell carcinoma — new aspects of diagnosis and treatment. Acta Derm Venereol Suppl 209:5–25.Google Scholar

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© Springer-Verlag Berlin Heidelberg 2002

Authors and Affiliations

  • Birgit Woerle
  • Marc Heckmann
  • Birger Konz

There are no affiliations available

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