XXXX , an underemphasized locally aggressive variant: a 20-year experience.

@entity1 @entity6461 @entity146 @entity5 @entity957 @entity3985 @entity189 @entity2269 @entity3808 @entity3 @entity204
BACKGROUND: @entity2269 (sclerosing) responses to a variety of @entity5 have been documented but rarely evaluated in association with primary @entity957 ( @entity6461 ). We report a distinctive variant of @entity6461 demonstrating an infiltrative growth pattern and @entity3985 . METHODS: Cases were identified through a retrospective review of our dermatopathology and dermatologic surgery databases. After initiation of the study, additional cases were identified prospectively. Neoplasms were scored microscopically for specific histopathologic parameters and reactivity with selected histochemical and immunohistochemical stains. Clinical follow-up data were obtained through a review of medical records or contact with the @entity1 's referring physicians. RESULTS: Seventy-three @entity189 from 72 @entity1 were identified (46 @entity1 , 26 @entity1 ; median age 76, range 45-91). The original pretreatment biopsies were available in 69 of 73 cases. All lesions developed on sun-damaged skin, with the cheek constituting the most common site. The clinical presentation was typically as a @entity3808 . All @entity5 extended into the reticular dermis or subcutaneous fat, and @entity3 was identified in 53 cases (73%). @entity1 who underwent standard excisional surgery experienced a recurrence rate of 80%; 9% of those treated with micrographic surgery experienced postoperative recurrences. @entity3 or @entity204 was not observed in any @entity1 during the follow-up period (median 36 months). CONCLUSIONS: Our results suggest that desmoplasia is uncommonly found in association with cutaneous @entity6461 but helps define a @entity146 . In light of the infiltrative nature of desmoplastic @entity6461 of the skin and the high incidence of @entity3 , micrographic surgery is the surgical modality of choice.
