Is It Typical to Need Mohs Surgery on Your Shoulder?

Mohs surgery is typically reserved for the areas of the head, the neck, the hands, and genitalia .  There are a few appropriate situations where it may be done on the trunk or extremities.   In these situations, the tumor can be of a large size (>2 cm in diameter), or the tumor can exhibit aggressive histology (poorly differentiated squamous cell carcinoma or an infiltrative basal cell carcinoma are a couple of examples). 

If you have a fairly small, well to moderately differentiated SCC, then I would probably say that Mohs is not indicated and a simple excision would suffice.  Be very careful, as there are several doctors out there who use Mohs inappropriately.  There is a fairly well-defined criteria where it should be used. 

Mohs surgery is usually reserved for areas where we try to preserve as much skin as possible. Typically on areas like the trunk, arms, legs, you can take a wider excision because it's easier to close and there is more skin to give. On areas like the face, hands, genitals, ears, etc. we need to make the smallest excisions possible and preserve as much skin as possible, so we only excise small areas level by level, widening and deepening only in needed areas, as are read during slides prepped during the Mohs procedure.

With all of that being said, if you have had this SCC removed more than once, or if it is extremely large, then a Mohs procedure might be necessary. For specifics on why your physician is recommending this, you need to ask him/her why the procedure is needed.

The procedure might cost you between $1000-$2000, depending on the number of slides made, the number of levels done during the procedure, and the type of closure done.