ORIGINAL ARTICLE   Free access

Italian Journal of Dermatology and Venereology 2021 October;156(5):610-5

DOI: 10.23736/S2784-8671.20.06576-1

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Basal cell carcinoma thickness evaluated by high-frequency ultrasounds and correlation with dermoscopic features

Rosa COPPOLA ¹ ✉, Mauro BARONE ¹, Salvatore ZANFRAMUNDO ², Valeria DEVIRGILIIS ¹, Vincenzo ROBERTI ³, Eleonora PERRELLA ⁴, Michele DONATI ⁴, Enzo PALESE ⁵, Stefania TENNA ¹, Paolo PERSICHETTI ¹, Vincenzo PANASITI ¹

¹ Unit of Plastic and Reconstructive Surgery, Campus Bio-Medico University, Rome, Italy; ² Department of Dermatology, University of Pisa, Pisa, Italy; ³ Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy; ⁴ Department of Pathology, Campus Bio-Medico University, Rome, Italy; ⁵ Unit of Dermatologic Surgery and Laser Therapy, IRCCS Istituto Dermopatico dell’Immacolata (IDI), Rome, Italy

BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer, and it can be easily treated by surgery or by various other physical modalities and topical chemotherapy. For metastatic, locally advanced BCC and for cancers that cannot be removed by surgery, systemic drugs known as hedgehog pathway blocker are used. High-frequency ultrasound (HFUS) is a non- invasive technique used in diagnosis of some skin cancers. It has proven potentially useful for BCC management. In this study we used high frequency ultrasounds to evaluate BCCs’ thickness and the correlation with dermoscopic features.
METHODS: We examined 86 basal cell carcinomas with dermoscopy and with high-frequency ultrasound. The main patterns identified by ultrasound were linear, ellipsoid and non-specific or undefined. Patients were divided by sex and age. The BCCs were grouped by anatomic location. Finally, we recorded specific dermoscopic features of BCCs noting their presence/absence in lesions overall and in each of four quadrants. Then the lesions were excised, and histological examination was made with definition of tumor thickness (in mm).
RESULTS: In our study, two main echographic patterns were described: linear, associated with superficial BCC, and ellipsoid, found primarily in nodular variants. However, a small percentage of lesions have otherwise non-specific patterns. We observed a significant correlation between echographic tumor thickness and histotype. We observed high concordance between histological tumor thickness and ultrasounds. Also, dermoscopic criteria as large branching and blue ovoid nests were significantly associated with heightened histologic and echographic assessments of tumor thickness.
CONCLUSIONS: Our study confirmed the utility of ultrasound in the diagnosis of BCCs and for the first time we have correlated ultrasounds’ patterns with dermoscopy and tumor thickness.

KEY WORDS: Carcinoma, basal cell; Skin neoplasms; Ultrasonography