Would you offer adjuvant radiation for a <1 cm preauricular sebaceous carcinoma after wide local excision?
Patient underwent a shave biopsy of a 6x5x2mm preauricular lesion that showed moderatley differentiated sebaceous carcinoma with deep and lateral margins positive. Patient went to an ENT who performed a wide local excision removing a 3.5 x 2 x 0.4 cm specimen of tissue and pathology showed no carcinoma. No perineural invasion was mentioned on the pathology report.
Answer from: Radiation Oncologist at Academic Institution
I limit the use of postoperative radiation therapy to those cases where there is a moderate likelihood of residual tumor that could develop into a clinical recurrence. In this case, I would have expected the shave biopsy to have positive margins. The lesion was then widely resected by a ...
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