Why Does my Mohs Procedure Take 3 Weeks ? Or More?

I was diagnosed with cellular dermatofibroma (1.5cm) on my right shoulder and had it surgically removed. After pathological testing it appeared it wasn't removed completely. A 2nd attempt proved the same result. Now doctors are suggesting an adjusted Mohs procedure, in 3 stages with 1 week in between, leaving an open wound during that time. They say they need 1 week for testing because the staining takes a lot of time. Is this normal, because I am reading everywhere Mohs is a same day procedure

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shoulder dermatofibroma treatment time

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3 Doctor Answers | Asked by kurt_be

Doctor Answers (3)
Community Comments (2)

Immunohistochemical stains take time...

I wouldn't call what you are having "Mohs". You might call it the slow Mohs variant if they are really doing en face sectioning of the tissue. More appropriately, I would say that you are having staged excisions where they are doing permanent sections with immunohistochemical stains. This is not abnormal to do for rare tumors. The staining and processing take time when it is done this way. The same day procedure that you read about for Mohs is... more

Mohs Surgery for Skin Cancer: One Day or More?

By definition Mohs surgery requires that one person act as surgeon and pathologist. If one of these duties is delegated to another person, by definition it is not Mohs surgery. It may be a staged excision or they may be orienting the tissue so that they see the greatest percentage of the peripheral and deep surgical margins, but it should not be described or billed as Mohs surgery. It may be that in your case this is the best option for treatment of your lesion. They may feel that they... more

Recurrent cancer procedures

I agree with Dr. Spencer. By definition what you are having done isn't a Mohs procedure, and yes, those are same day procedures. What you are having done is a multi-staged cancer removal. Sometimes when aggressive cancers recur (which yours has done several times now) a regular excision just isn't going to work. So you do what's considered a staged excision with multiple sections removed, sent to a specialized lab, and stained with multiple types of stain. The allows your physician to see... more

Comments (2)

kurt_be 19 Jul 2012

Thank you for your help. I just wish to point out though that the doctors have insisted the tumor is not malignant after thorough testing and staining, although it has a high possibility of recurring if not removed properly.
The previous 2 procedures were not enough to remove the tumor completely, so it's not really recurring (yet) because they haven't succeeded in its full removal yet.
I had this for over 10 years and showed it to at least 3 dermatologists before, who all said it's basal cell carcinoma and didn't need removing. Otherwise I wouldn't have waited so long in having the surgery. I finally got another opinion after the tumor grew bigger over the past 2 years or so.

kurt_be 19 Jul 2012

Thanks a lot for your helpful answer.
Would it be a big mistake not going through with the procedure, since (cellular) dermatofibroma is benign and (almost) never metastises, apart from a few case reports ?

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