{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T18:22:32Z","timestamp":1791829352312,"version":"4.3.4"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"11-12","license":[{"start":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T00:00:00Z","timestamp":1558656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Microcystic adnexal carcinoma (MAC) is a rare, malignant cutaneous neoplasm that often presents as an inconspicuous, benign appearing lesion. Patients most commonly are asymptomatic and present for improved cosmesis, however perineural invasion may result in local numbness, paresthesia or pruritus. Although distant metastasis is rare, MAC has an increased propensity for local invasion, often resulting in significant morbidity as late presentation and misdiagnosis are common. A high index of suspicion is imperative, and deep tissue biopsy with defining histologic characteristics is required for diagnosis. Mohs micrographic surgery is currently the standard of care, providing the highest possibility for long-term cure. We present a case report of a 43-year-old male Air Force U-2 pilot with a benign presentation and initial clinical misdiagnoses of MAC, who underwent Mohs micrographic surgery followed by cervicofacial flap reconstruction of a 5.5 \u00d7 3.5 cm defect. We also identify increased radiation exposure of U-2 pilots as a potential risk factor for the early development of MAC, emphasizing the importance of exploring patient risk factors while having a high index of suspicion to aid in early diagnosis.<\/jats:p>","DOI":"10.1093\/milmed\/usz123","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T12:30:39Z","timestamp":1558701039000},"page":"948-950","source":"Crossref","is-referenced-by-count":7,"title":["Microcystic Adnexal Carcinoma: A Rare, Commonly Misdiagnosed Malignancy"],"prefix":"10.1093","volume":"184","author":[{"given":"Claire D","family":"Gerall","sequence":"first","affiliation":[{"name":"AirMed Program, MCMR-SRZ-B, 3698 Chambers Pass Ste B, JBSA Ft. Sam Houston, TX 78234"},{"name":"Department of Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R","family":"Sippel","sequence":"additional","affiliation":[{"name":"AirMed Program, MCMR-SRZ-B, 3698 Chambers Pass Ste B, JBSA Ft. Sam Houston, TX 78234"},{"name":"Department of Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaclyn L","family":"Yracheta","sequence":"additional","affiliation":[{"name":"AirMed Program, MCMR-SRZ-B, 3698 Chambers Pass Ste B, JBSA Ft. Sam Houston, TX 78234"},{"name":"Department of Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawn S","family":"Hogan","sequence":"additional","affiliation":[{"name":"AirMed Program, MCMR-SRZ-B, 3698 Chambers Pass Ste B, JBSA Ft. Sam Houston, TX 78234"},{"name":"Department of Plastic Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Drive Bldg 3600, JBSA Fort Sam Houston, TX 78234"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,5,24]]},"reference":[{"issue":"8","key":"2019121323272890500_usz123C1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1097\/DSS.0000000000001142","article-title":"Microcystic adnexal carcinoma: a review of the literature","volume":"43","author":"Gordon","year":"2017","journal-title":"Dermatol Surg"},{"issue":"3","key":"2019121323272890500_usz123C2","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1002\/1097-0142(19820801)50:3<566::AID-CNCR2820500330>3.0.CO;2-Q","article-title":"Microcystic adnexal carcinoma: a distinct clinicopathologic entity","volume":"50","author":"Goldstein","year":"1982","journal-title":"Cancer"},{"issue":"2","key":"2019121323272890500_usz123C3","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.jdds.2015.03.001","article-title":"Microcystic adnexal carcinoma: a focused review and updates","volume":"19","author":"Hamed","year":"2015","journal-title":"J Dermatol Dermatol Surg"},{"issue":"10","key":"2019121323272890500_usz123C4","first-page":"1035","article-title":"Clinical course, risk factors, and treatment of microcystic adnexal carcinoma: a short series report","volume":"29","author":"Abbate","year":"2003","journal-title":"Dermatol Surg"},{"issue":"8","key":"2019121323272890500_usz123C5","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/S0001-7310(09)72282-3","article-title":"Microcystic adnexal carcinoma: mohs micrographic surgery as the treatment of choice","volume":"100","author":"Martorell-Calatayud","year":"2009","journal-title":"Actas Dermosifiliogr"},{"key":"2019121323272890500_usz123C6","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1016\/B978-1-4377-1637-5.00039-0","volume-title":"Clinical Radiation Oncology, Third Edition","author":"Veness","year":"2012"},{"issue":"1","key":"2019121323272890500_usz123C7","doi-asserted-by":"crossref","first-page":"16","DOI":"10.4103\/oji.oji_8_17","article-title":"Microcystic adnexal carcinoma of face a rare aggressive pathology","volume":"1","author":"Debata","year":"2017","journal-title":"Oncol J India"},{"issue":"1","key":"2019121323272890500_usz123C8","doi-asserted-by":"crossref","first-page":"43","DOI":"10.7181\/acfs.2015.16.1.43","article-title":"Microcystic adnexal carcinoma misdiagnosed as desmoplastic trichoepithelioma on preoperative biopsy","volume":"16","author":"Koh","year":"2015","journal-title":"Arch Craniofac Surg"},{"issue":"12","key":"2019121323272890500_usz123C9","doi-asserted-by":"crossref","first-page":"2708","DOI":"10.1016\/j.joms.2017.08.006","article-title":"The cervicofacial flap in cheek reconstruction: a guide for flap design","volume":"75","author":"Al Shetawi","year":"2017","journal-title":"J Oral Maxillofac Surg"},{"issue":"3","key":"2019121323272890500_usz123C10","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.cps.2009.02.003","article-title":"Maximizing results in reconstruction of cheek defects","volume":"36","author":"Mureau","year":"2009","journal-title":"Clin Plast Surg"},{"key":"2019121323272890500_usz123C11","author":"Phillips","year":"2013"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/184\/11-12\/948\/31509920\/usz123.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/milmed\/article-pdf\/184\/11-12\/948\/31509920\/usz123.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T21:49:52Z","timestamp":1694900992000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/184\/11-12\/948\/5498203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,24]]},"references-count":11,"journal-issue":{"issue":"11-12","published-online":{"date-parts":[[2019,5,24]]},"published-print":{"date-parts":[[2019,12,1]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usz123","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2019,11]]},"published":{"date-parts":[[2019,5,24]]}}}