Ex vivo fluorescent confocal microscopy to guide micrographic mohs surgery

Standard surgery is generally considered the treatment of choice for basal cell carcinomas (BCCs). However, even with surgery, there are several tumor characteristics that are associated with higher recurrence rates. These include tumors located around the eyes, nose, lips, and ears; morpheic, infiltrative, micronodular, and basosquamous histopathological subtypes; BCCs with ill-defined margins; recurrent lesions; incompletely excised lesions; and perineural or perivascular involvement. Thus, in these instances, BCCs are preferably treated with Mohs micrographic surgery (MMS), which allows for complete examination of all residual tumor margins, minimizing the risk of recurrence and avoiding unnecessary removal of healthy tissue.