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1.  Incidental Merkel cell carcinoma in a cutaneous horn: a case report 
Merkel cell carcinoma (MCC) is a rare cutaneous neuroendocrine malignancy, which usually presents as an asymptomatic, rapidly growing, firm nodule on sun-damaged skin. We present a 93-year-old female who presented with a “cutaneous horn” on the face. On excision, histologic examination revealed a combined squamous cell carcinoma in situ with underlying MCC. Merkel cell polyomavirus immunohistochemistry was negative in this lesion. This case report highlights the significant association between MCC and squamous cell carcinoma and the uncommon clinical presentation of this combined tumor in the form of a cutaneous horn.
doi:10.5826/dpc.0501a08
PMCID: PMC4325691
Merkel cell carcinoma; squamous cell carcinoma; cutaneous horn
3.  Obtaining high cure rates for challenging facial malignancies: A new method for producing rapid, accurate, high-quality frozen sections 
PURPOSE:
The authors developed a new system to provide rapid, accurate, full-face frozen sections.
OBJECTIVE:
To evaluate the efficacy of the system when applied to the treatment of nonmelanoma cutaneous malignancies using Mohs micrographic surgery (MMS).
METHODS:
Patients undergoing MMS procedures between 2003 and 2007 for nonmelanoma head and neck cutaneous malignancies were prospectively collected. Specimens were prepared either in a traditional cryostat-based manner or using the new system.
RESULTS:
A total of 196 patients with 234 head and neck nonmelanoma cutaneous malignancies were included. The majority of tumours were basal cell carcinomas (89.5%). Of these, 38% demonstrated aggressive histologies (sclerosing or micronodular), and 30% were recurrent. On average, two levels (range one to six) and four blocks (range two to 23) were required to obtain clear margins. The mean defect size was 3.68 cm2 (range 0.13 cm2 to 37.68 cm2). Over the five-year study period, there were two recurrences in 234 cases (less than 1%), which compares favourably with other MMS series. The new system was associated with a shorter operative time than traditional specimen preparation (102 min versus 131 min; P=0.004). The new and traditional specimen preparation groups were similar in terms of the number of previous recurrences (29% versus 30%; P=1.00), defect size (3.7 cm2 versus 4.0 cm2; P=0.81) and the number of levels required (1.9 versus 1.5; P=0.05).
CONCLUSIONS:
The new system enables fast, accurate, full-face frozen section specimens that are ideal for MMS. The speed of specimen preparation is demonstrated by faster operative times, and a low recurrence rate attests the accuracy and quality of the sections.
PMCID: PMC3086501  PMID: 22379370
Conforming plane; CryoCaddy; Disposable base mold embedding; Mohs micrographic surgery; Platform mold

Results 1-3 (3)