Surgical Treatment of Trichoblastic Carcinoma: A Systematic Review

Trichoblastic carcinoma (TBC) is a rare cutaneous malignancy that arises de novo or from the malignant transformation of a preexisting trichoblastoma. Although surgery is the most common treatment, the analysis of outcomes and recurrence rates between Mohs micrographic surgery (MMS) and traditional excision is limited. We analyzed the outcomes of MMS and traditional excision for TBC based on published recurrence and metastasis data. In May 2024, a systematic review was conducted utilizing PubMed, Scopus, Embase, and Web of Science databases to identify articles addressing TBC treatment with excision and/or MMS. Thirty-one articles were included, yielding 128 patients and 128 surgical operations. Approximately 9.5% (2/21) of cases treated with MMS recurred after follow-up, compared to 8.4% (9/107) of cases resected with traditional excision. Our study suggests that both MMS and traditional excision are comparably effective options for TBC, with similar recurrence rates. The choice of surgical modality may depend on the need for tissue sparing in sensitive anatomical locations. The limited data available underscore the need for further comparative studies to establish the optimal surgical approach.