A. Bulinska1, Ya. Zaychenko2, А. Kucher2, I. Mota3
1School of Medicine, The University of Queensland, Brisbane, Australiа
2Danylo Halytsky Lviv National Medical University
3ULTRAMED Ultrasound Diagnostics Center
Introduction. Basal cell carcinoma of the skin is the most common skin cancer in people with fair skin color. Early detection of basal cell carcinoma and proper surgical approach are crucial to reduce the incidence of this tumor. Visual examination is the first screening tool used by clinicians, but sometimes it is not enough to differentiate and determine treatment tactics. Therefore, non-invasive methods such as dermatoscopy and ultrasonography of the skin have recently become widely used, which provide a clear diagnosis, fully correlate with the pathomorphological diagnosis and allow determining the invasiveness of the process and the scope of surgery.
The aim of the study. To establish the effectiveness of the diagnosis of basal cell carcinoma of the skin using dermatoscopy in combination with ultrasound, to clarify and justify the feasibility of using a double diagnostic test “Dermatoscopy + Ultrasound” in the diagnosis of skin tumors for future surgery.
Materials and methods. Two cases of basal cell basal cell carcinoma in young patients with atypical localization, dermatoscopic and ultrasonographic parameters, correlation with pathomorphological diagnosis are described. Dermatoscopic parameters were evaluated according to G. Kittler’s algorithm, skin ultrasound was performed on an expert class device “ACUSON Juniper Ultrasound System” with color and energy Doppler modes by a linear multifrequency transducer (5-17MHz) according to the original protocol developed by G.Alakhverdian.
Results. A feature of the described clinical cases is the young age of patients (21 and 29 years), which is an atypical phenomenon in relation to the manifestations of BCC and indicates that recently basal cell carcinoma begins to occur at a young age and its typical location changes. The obtained data of dermatoscopic and ultrasonographic examination confirm specific clinical symptoms and are completely correlated with pathomorphological diagnosis.
Conclusions. Dermatoscopy in combination with skin ultrasonography are reliable non-invasive techniques that allow real-time detection of clinical and subclinical lesions and should be used to diagnose and monitor for all skin cancers.
- Allakhverdyan GS, Chekalova MA, Mikhailova IN. Ultrasound semiotics of tumor changes in the lumbar lymph nodes. Journal of Oncology, Radiation Diagnostics, Radiation Therapy. 2018;1(3):31-35. (Russian)
- Kabanova MA, Volgin VN, Popova NM, Sachek OI, Shelepova EA. Clinical manifestations of basal cell skin cancer and the effectiveness of patient treatment. Modern Problems of Health Care and Medical S 2018;2:28-35. (Russian)
- Kazakov SV, Shcherbak SG. A clinical case of basal cell carcinoma of the skin. Clinical Dermatology and Venereology. 2017;16(2):16-18. (Russian) https://doi.org/10.17116/klinderma201716216-18
- Kittler G, Rosenthal K, Cameron A, Tsandl F, Kiladze N, Bulinska A, Shulaia T. Dermatoscopy, an algorithmic method based on pattern analysis. Via Medica; 2011. 322 p. (Russian)
- Khlebnikova AN, Novoselova NV. Dermatoscopic criteria for basaliomas of various morphological structures. Almanac of Clinical Medicine. 2014;34:65-70. (Russian)
- Bobadilla F, Wortsman X, Muñoz C, Segovia L, Espinoza M, Jemec G. Presurgical high resolution ultrasound of facial basal cell carcinoma: Correlation with histology. Cancer Imaging. 2008;8:163-172. https://doi.org/10.1102/1470-7330.2008.0026
- Bouer M, Chammas M, Messina M, Cerri G. Squamous cell carcinoma (SCC) of the skin: Description of ultrasound and power doppler findings before and after the use of microbubble contrast and association with degree of malignancy. Ultrasound Med Biol. 2009;35:S220. https://doi.org/10.1016/j.ultrasmedbio.2009.06.833
- Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, in press. The online GLOBOCAN 2018 database is accessible at http://gco.iarc.fr/, as part of IARC’s Global Cancer Observatory. Available from: https://www.wcrf.org/dietandcancer/cancer-trends/skin-cancer-statistics. https://doi.org/10.3322/caac.21492
- Cameron MC, Lee E, Hibler BP, Barker CA, Mori S, Cordova M et al. Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol. 2019;80(2):303-317. https://doi.org/10.1016/j.jaad.2018.03.060
- Gloster HM, Neal K. Skin cancer in skin of color. J Am Acad Dermatol. 2006;55(5):741-760. https://doi.org/10.1016/j.jaad.2005.08.063
- Marzuka AG. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med. 2015;88(2):167-179.
- Miller SJ. Biology of basal cell carcinoma (Part I). J Am Acad Dermatol. 1991;24(1):1-13. https://doi.org/10.1016/0190-9622(91)70001-I
- Mogensen M, Jemec GB. Diagnosis of nonmelanoma skin cancer/keratinocyte carcinoma: A review of diagnostic accuracy of nonmelanoma skin cancer diagnostic tests and technologies. Dermatol Surg. 2007;33(10):1158-1174. https://doi.org/10.1097/00042728-200710000-00003
- Nouri K, Ballard CJ et al. Basal cell carcinoma. In: Nouri K et al. Skin Cancer. McGraw Hill Medical, China; 2008. P. 61-81.
- Preminger BA, Talmor M, Specht MC, Suzman M, Hoffman LA. The legacy of Icarus in the 21st century: report of a case of aggressive submental basal cell carcinoma resulting from frequent use of a metallic ultraviolet reflector. Ann Plast Surg. 2001;46(2):192-193. https://doi.org/10.1097/00000637-200102000-00026
- Radiation: Ultraviolet (UV) radiation and skin cancer/16 October. 2017. Available from: https://www.who.int/news-room/q-a-detail/radiation-ultraviolet-(uv)-radiation-and-skin-cancer
- Bader RS. Basal cell carcinoma. William DJ, ed. 2021. Medscape. Available from: https://emedicine.medscape.com/article/276624-overview
- Wortsman X. Sonography of facial cutaneous basal cell carcinoma: a first-line imaging technique. J Ultrasound Med. 2013;32(4):567-572. https://doi.org/10.7863/jum.2013.32.4.567
- Wu S, Han J, Li WQ, Li T, Qureshi AA. Basal-cell carcinoma incidence and associated risk factors in US men and women. Am J Epidemiol. 2013:178(6):890-897. https://doi.org/10.1093/aje/kwt073