Though rare, dermatologic surgeons are very familiar with these tumors.
Some such as Atypical fibroxanthoma (AFX)., Microcystic Adnexal Carcinoma (MAC), Adenoid Cystic Carcinoma (ACC) Sebaceous Carcinoma, and Extra-Mammary Paget’s Disease (EMPD)are particularly suitable for treatment with Mohs Surgery. Others are better treated with Mapped Serial Excision, for example malignant Fibrous Histiocytoma (MHH), Dermatofibromsarcoma Protuberans (DFSP) and Leiomyosarcoma (LMS).
An extremely rare tumor, Merkel Cell carcinoma, (MCC) is increasing in incidence, and is particularly seen in immunosuppressed individuals and in the elderly. It is possibly the most malignangt of all skin cancer sitha marked tendance forealy ddissemination throughout the body. It is treated by excision, with subsequent radiotherapy. Interestingly, an oncogenic (cancer causing) virus has been identified as the likely cause of MCC
It is essential that these cancers be diagnosed early in order to achieve the highest chance of cure.