Clinical value of paraffin sections in association with mohs micrographic surgery for nonmelanoma skin cancers Journal Article


Authors: Ebede, T. L.; Lee, E. H.; Dusza, S. W.; Busam, K. J.; Nehal, K. S.
Article Title: Clinical value of paraffin sections in association with mohs micrographic surgery for nonmelanoma skin cancers
Abstract: Background During Mohs micrographic surgery (MMS), situations can arise in which paraffin sections may be used in conjunction with frozen sections. Objective To determine the clinical value of paraffin sections in association with MMS, including frequency, reasons, and information obtained. Methods and Materials Single-center retrospective cohort study at a cancer center. MMS cases for nonmelanoma skin cancers over a 5-year period in which paraffin sections were used were identified. Reasons for submitting paraffin sections were reviewed. Initial biopsy, Mohs frozen section, and paraffin section diagnoses and histologic subtypes were compared. Results In 258 (7.8%) cases, paraffin sections were used in association with MMS. The most common reasons were to further assess high-risk histologic features or unusual frozen section findings, to complete tumor staging of cutaneous squamous cell carcinomas, and to assess perineural invasion (PNI). Initial biopsy diagnosis differed from the Mohs frozen and paraffin section diagnoses in 20% to 22% of cases. The initial biopsy histologic subtype changed from low or indeterminate to high risk in Mohs frozen and paraffin sections in 24% to 29% of cases. Conclusion In MMS for select high-risk or unusual nonmelanoma skin cancers, paraffin sections are useful in more accurately documenting tumor histology, completing cutaneous squamous cell carcinoma staging, and detecting PNI. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.
Keywords: adult; aged; aged, 80 and over; middle aged; retrospective studies; young adult; major clinical study; clinical feature; histopathology; carcinoma, squamous cell; cancer staging; cancer diagnosis; basal cell carcinoma; skin biopsy; skin neoplasms; cohort analysis; retrospective study; biopsy; skin carcinoma; cancer invasion; skin; cancer center; chi-square distribution; invasive carcinoma; perineurium; frozen section; carcinoma, basal cell; chemosurgery; frozen sections; mohs micrographic surgery; peripheral nervous system; paraffin; paraffin embedding; bowen disease; non melanoma skin cancer
Journal Title: Dermatologic Surgery
Volume: 38
Issue: 10
ISSN: 1076-0512
Publisher: Lippincott Williams & Wilkins  
Date Published: 2012-10-01
Start Page: 1631
End Page: 1638
Language: English
DOI: 10.1111/j.1524-4725.2012.02570.x
PROVIDER: scopus
PUBMED: 22958072
DOI/URL:
Notes: --- - "Export Date: 2 November 2012" - "CODEN: DESUF" - "Source: Scopus"
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MSK Authors
  1. Kishwer S Nehal
    278 Nehal
  2. Stephen Dusza
    288 Dusza
  3. Erica H Lee
    135 Lee
  4. Klaus J Busam
    688 Busam