Primary cutaneous mucinous carcinoma of the eyelid treated with Mohs surgery

Primary mucinous carcinoma (PCMC) is a rare, slow-growing mucinous variant of sweat gland tumors. Clinically, PCMC presents with a variety of morphologies and most commonly affects the eyelid or brow followed by the neck and scalp.1 According to a recent meta-analysis by Kamalpour et al,1 approximately 215 cases of PCMC have been reported from 1952 to 2010, with an increased prevalence in whites, elderly, and men. Most of these cases (136 of 159) were treated with traditional surgical excision with 1-cm minimum margins, and only a limited number (15 of 159) were treated with MMS. Of the patients treated with Mohs micrographic surgery (MMS), 2 (13%) had recurring disease with no reported metastases. In contrast, 46 patients (34%) either had recurrence of disease or disease that metastasized when treated with wide local excision. Overall, the rate of PCMC metastasis was low (6.1%), and the rate of local recurrence was high (19.6%). Mean follow-up time was 30.1 (standard deviation, 39.4) months for patients treated with excision and 23.1 (standard deviation, 17.5) months for patients treated with MMS.1 We describe a patient with PCMC of the eyelid treated with MMS who has shown no evidence of recurrence for a longer follow-up period than currently reported in the literature.