Chapter 083. Cancer of the Skin (Part 10) Other Nonmelanoma Cutaneous Malignancies Neoplasms of cutaneous adnexa and sarcomas of fibrous, mesenchymal, fatty, and vascular tissues make up 1–2% of NMSC (Table 83-6). Some can portend a poor prognosis such as Merkel cell carcinoma, which is a neural crest- derived, highly aggressive malignancy that exhibits a metastatic rate of 75% and a 5-year survival rate of 30–40%. Others, such as the human herpes virus 8-induced, HIV-related Kaposi's sarcoma, exhibit a more indolent course. The marked decrease in incidence of this tumor parallels the institution of the highly active antiretroviral therapy. Table 83-6 Other Nonmelanoma Cutaneous Malignancies Tumor Type Most Common Location Recurrenc e Rate, a % Metastati c Rate, % Atypical fibroxanthoma Head and neck 21 4 Merkel cell carcinoma Head and neck 40 75 Dermatofibrosarcom a protuberans Trunk 50 1 Sebaceous carcinoma Eyelid 12 30 Microcystic adnexal carcinoma Face 50 1 case Porocarcinoma Extremit 20 10 y Eccrine carcinoma Head and neck 36 11 Angiosarcoma Head and neck 75 75 a Recurrence rates are the highest reported and were established prior to widespread use of Mohs micrographic surgery. Acknowledgment Katarina G. Chiller, MD, and Howard K. Koh, MD, contributed to this chapter in the 16th edition and material from that chapter is included here Further Readings American Cancer Society: Website at www.cancer.org Balch CM et al : Prognostic factors analysis of 17,600 melanoma patients: Validation of the American Joint Committee on Cancer melanoma staging system. J Clin Oncol 19:3622, 2001 [PMID: 11504744] Balch CM et al: Final version of the AJCC staging system for cutaneous melanoma. J Clin Oncol 19:3635, 2001 [PMID: 11504745] Drake LA et al: Guidelines of care of basal cell carcinoma. J Am Acad Dermatol 26:117, 1992 [PMID: 1732317] ——— et al: Guidelines of care for cutaneous squamous cell carcinoma. J Am Acad Dermatol 28:628, 1993 Geisse JK et al: Imiquimod 5% cream for the treatment of superficial basal cell carcinoma: A double-blind, randomized, vehicle- controlled study. J Am Acad Dermatol 47:390, 2002 [PMID: 12196749] Johnson TM et al: Staging workup, sentinel node biopsy, and follow- up tests for melanoma: Update of current concepts, Arch Dermatol 140:107, 2004 [PMID: 14732667] Morton DL et al: Sentinel- node biopsy on nodal observation in melanoma. N Engl J Med 355:1307, 2006 [PMID: 17005948] Petrella T et al: Single agent interleukin- 2 in the treatment of metastatic melanoma: A systematic review. 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