Complete Mohs microscopic margin assessment requires excision of intact, contiguous tissue at both the peripheral and deep margins. Integrity of the deep margin may not be possible for deeply invasive tumors that extend to anatomic structures that are difficult to resect under local anesthesia (eg, bone) or whose resection would increase surgical morbidity (eg, tendon) or would benefit from care by other subspecialties. Precisely marking the holes in the soft tissue excision can guide further targeted resection.
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