Preoperative Mohs Paste Treatment for a Subcutaneous Sarcoma and a Skin Ulcer to Prevent Intraoperative Bleeding

INTRODUCTION: Mohs paste has a zinc chloride component and the ability to coagulate tissue. Mohs chemosurgery or surgery is a method by which coagulated tissue is removed and can be repeated until the tumor disappears. The palliative purpose of Mohs chemosurgery or surgery is to control bleeding or exudate from a malignancy with a skin ulcer. In the current report, a single application of Mohs paste as a pre-operative treatment for a superficial sarcoma with a skin ulcer prevented intra-operative bleeding. CASE REPORT: Two metastatic sarcomas are described: one in the scalp originating from a rectoperineal dedifferentiated liposarcoma and one in the elbow originating from a humeral telangiectatic osteosarcoma. Mohs paste treatment was performed the day before surgical resection. The Mohs paste procedure successfully prevented intra-operative bleeding from the tumor, leading to easy removal of the tumors with appropriate tumor-free margins. CONCLUSION: Preoperative Mohs paste treatment is a simple and reliable method. Intra-operative neoplastic bleeding may contaminate the tumor cells within the surgical field; thus the prevention of bleeding with Mohs paste treatment may lead to a decrease in the tumor recurrence rate.