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Grade I or II MCTs that are Kiupel low grade excised with complete surgical margins do not require any adjuvant therapy as the risk for local recurrence (5–11%) or metastasis is relatively low (Murphy et al. 2004; Séguin et al. 2001; Weisse et al. 2002; Michels et al. 2002). Patients should be evaluated regularly for signs of local recurrence and any new cutaneous masses should be thoroughly investigated. Grade III MCTs that are completely excised have a low chance for local recurrence but a high chance to develop metastatic disease. As such, these cases should receive adjunctive chemotherapy to delay or prevent metastatic spread. Kiupel high‐grade tumors have a local recurrence rate of 18–36%, even when margins are complete (Donnelly et al. 2015; Moore 2020).