This study examined the clinical significance of anticipated versus unanticipated incomplete excisions during Mohs micrographic surgery. Unanticipated positive margins were associated with more aggressive tumor biology and required additional stages, highlighting the need for careful preoperative assessment and margin planning.

Unanticipated positive margins in Mohs surgery may indicate more aggressive tumor behavior and should prompt careful re-evaluation.

Thorough preoperative clinical assessment helps predict subclinical tumor extension and reduce unanticipated incomplete excisions.