Squamous cell carcinoma of the auricle and Mohs micrographic surgery.

Background: Squamous cell carcinoma (SCC) of the ear compared with SCC occurring at other skin sites has an increased incidence of recurrence following treatment.

Objective: To determine the following variables: patient age and gender, life status, tumor location, and recurrence rate following Mohs micrographic surgery (MMS).

Methods: The charts of 117 patients with 144 invasive SCCs of the auricle were reviewed. The patients were contacted by telephone to confirm tumor recurrence and patients' life status. The range of follow-up was 7 to 67 months (average 34.6 months) after MMS.

Results: The patients' ages ranged from 34 to 90 years (mean age 71 years). The male to female ratio was 22:1. The helix was the most common site of occurrence (50.7%). Local recurrence after MMS was found in four patients (five tumors). MMS was performed on these five recurrent tumors, with no further recurrences. Telephone confirmation was obtained on 91 patients (26 patients could not be contacted) with 122 tumors, which included the 4 patients with 5 recurrent tumors. There were no additional recurrences. Of these 122 tumors, 35 were followed for less than 2 years (average 16.6 months), and 87 were followed for 2 years or more (average 41.8 months). From the chart review and telephone contact, the 2-year local recurrence rate was 5.7% (5 of 87 tumors) after MMS. The average size of these 87 tumors was 3.5 cm2. Twelve of 91 patients had died with evidence of active disease from causes unrelated to SCC.

Conclusion: Invasive SCC of the ear was once a formidable disease with a severe prognosis. The course of this disease has been appreciably improved by early diagnosis and treatment with MMS.