A new approach for presurgical margin assessment by reflectance confocal microscopy of basal cell carcinoma
Summary Background Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal. Objectives To propose a new approach through the combi...
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Published in | British journal of dermatology (1951) Vol. 174; no. 2; pp. 380 - 385 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.02.2016
Oxford University Press |
Subjects | |
Online Access | Get full text |
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Abstract | Summary
Background
Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal.
Objectives
To propose a new approach through the combination of dermoscopy and reflectance confocal microscopy (RCM) for lateral margin detection in BCC.
Methods
Ten patients with lesions clinically suggestive of nonpigmented BCCs with ill‐defined margins were enrolled. All BCCs were dermoscopically evaluated first and the ill‐defined margins were marked with a superficial cut and then inspected using RCM.
Results
RCM evaluation showed BCC foci beyond the presurgical marker in three out of 10 lesions. Histology confirmed the RCM results: the presence of BCC features across the cut, corresponding to two superficial BCCs and a morpheaform BCC.
Conclusions
This new procedure helped to improve the identification of proper margins for surgical excision in nonpigmented BCC with clinically and dermoscopically ill‐defined margins.
What's already known about this topic?
Mohs surgery is considered the most efficient technique for complete removal of basal cell carcinoma (BCC), but it is time consuming and expensive.
What does this study add?
The suggested procedure of dermoscopy combined with reflectance confocal microscopy helps to improve the identification of proper margins for surgical excision of BCC.
Plain language summary available online |
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AbstractList | BackgroundSurgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal.ObjectivesTo propose a new approach through the combination of dermoscopy and reflectance confocal microscopy (RCM) for lateral margin detection in BCC.MethodsTen patients with lesions clinically suggestive of nonpigmented BCCs with ill‐defined margins were enrolled. All BCCs were dermoscopically evaluated first and the ill‐defined margins were marked with a superficial cut and then inspected using RCM.ResultsRCM evaluation showed BCC foci beyond the presurgical marker in three out of 10 lesions. Histology confirmed the RCM results: the presence of BCC features across the cut, corresponding to two superficial BCCs and a morpheaform BCC.ConclusionsThis new procedure helped to improve the identification of proper margins for surgical excision in nonpigmented BCC with clinically and dermoscopically ill‐defined margins. Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal. To propose a new approach through the combination of dermoscopy and reflectance confocal microscopy (RCM) for lateral margin detection in BCC. Ten patients with lesions clinically suggestive of nonpigmented BCCs with ill-defined margins were enrolled. All BCCs were dermoscopically evaluated first and the ill-defined margins were marked with a superficial cut and then inspected using RCM. RCM evaluation showed BCC foci beyond the presurgical marker in three out of 10 lesions. Histology confirmed the RCM results: the presence of BCC features across the cut, corresponding to two superficial BCCs and a morpheaform BCC. This new procedure helped to improve the identification of proper margins for surgical excision in nonpigmented BCC with clinically and dermoscopically ill-defined margins. Summary Background Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo determination of tumour margin, in order to achieve radical removal. Objectives To propose a new approach through the combination of dermoscopy and reflectance confocal microscopy (RCM) for lateral margin detection in BCC. Methods Ten patients with lesions clinically suggestive of nonpigmented BCCs with ill‐defined margins were enrolled. All BCCs were dermoscopically evaluated first and the ill‐defined margins were marked with a superficial cut and then inspected using RCM. Results RCM evaluation showed BCC foci beyond the presurgical marker in three out of 10 lesions. Histology confirmed the RCM results: the presence of BCC features across the cut, corresponding to two superficial BCCs and a morpheaform BCC. Conclusions This new procedure helped to improve the identification of proper margins for surgical excision in nonpigmented BCC with clinically and dermoscopically ill‐defined margins. What's already known about this topic? Mohs surgery is considered the most efficient technique for complete removal of basal cell carcinoma (BCC), but it is time consuming and expensive. What does this study add? The suggested procedure of dermoscopy combined with reflectance confocal microscopy helps to improve the identification of proper margins for surgical excision of BCC. Plain language summary available online |
Author | Gualdi, G. Lorenzi, L. Venturini, M. Calzavara-Pinton, P.G. Zanca, A. Pellacani, G. |
Author_xml | – sequence: 1 givenname: M. surname: Venturini fullname: Venturini, M. email: marina.venturini@unibs.it organization: Department of Dermatology, University of Brescia, Brescia, Italy – sequence: 2 givenname: G. surname: Gualdi fullname: Gualdi, G. organization: Department of Dermatology, University of Brescia, Brescia, Italy – sequence: 3 givenname: A. surname: Zanca fullname: Zanca, A. organization: Department of Dermatology, University of Brescia, Brescia, Italy – sequence: 4 givenname: L. surname: Lorenzi fullname: Lorenzi, L. organization: Department of Pathology, University of Brescia, Brescia, Italy – sequence: 5 givenname: G. surname: Pellacani fullname: Pellacani, G. organization: Department of Dermatology, University of Modena and Reggio Emilia, Modena, Italy – sequence: 6 givenname: P.G. surname: Calzavara-Pinton fullname: Calzavara-Pinton, P.G. organization: Department of Dermatology, University of Brescia, Brescia, Italy |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26498991$$D View this record in MEDLINE/PubMed |
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Copyright | 2015 British Association of Dermatologists 2015 British Association of Dermatologists. Copyright © 2016 British Association of Dermatologists |
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Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been... Surgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for in vivo... BackgroundSurgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for... BACKGROUNDSurgical excision represents the most common elective treatment for basal cell carcinoma (BCC). Several noninvasive approaches have been proposed for... |
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SubjectTerms | Adult Aged Aged, 80 and over Basal cell carcinoma Carcinoma, Basal Cell - diagnostic imaging Carcinoma, Basal Cell - pathology Carcinoma, Basal Cell - surgery Confocal microscopy Dermoscopy - methods Female Humans Male Margins of Excision Microscopy Microscopy, Confocal - methods Middle Aged Preoperative Care - methods Reflectance Skin cancer Skin Neoplasms - diagnostic imaging Skin Neoplasms - pathology Skin Neoplasms - surgery Tumors |
Title | A new approach for presurgical margin assessment by reflectance confocal microscopy of basal cell carcinoma |
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