Six cas de carcinomes annexiels de la face avec reconstruction

Abstract

Adnexial carcinomas are a group of rare and aggressive malignant skin tumors. Management of these tumors is not well codified. The authors present a retrospective and single-center study of six cases. Surgery was performed between November 2005and February 2008. Pathological study revealed two syringoideccrine carcinomas, one microcystic adnexal carcinoma, two tricholemmal carcinomas, and one extra-ocular sebaceous neoplasm. In five cases, complete excision was guided by extemporaneous examination. In five cases, reconstructive surgery involved loco-regional skin flaps: two Abbé flaps, one Webster flap, one lifting lip flap, one submental flap, and one LLL flap. One case of relapse occurred, at 40months. Several particular characteristics of these tumors are shown in this study. They often follow a non-specific and discrete clinical course, are deeply infiltrated with a perineural tropism in some forms, and are preferentially located in the mid-face. Risks of incomplete excision and relapse are high. Complete excision is absolutely necessary in the management of these tumors, especially if reconstructive surgery is performed. Extemporaneous examination was in our experience a good option, particularly in the case of large labial or eyelid excisions.