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de Castro Martins IM, Espósito ACC, Miot HA. Oncological aspects related to non-surgical treatment of basal cell carcinoma. Comments on: chemotherapeutical treatment of basal cell carcinoma with bleomycin via microinfusion of the drug into the skin (MMP®). An Bras Dermatol 2024; 99:324-325. [PMID: 38071126 PMCID: PMC10943298 DOI: 10.1016/j.abd.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 08/28/2023] [Indexed: 03/11/2024] Open
Affiliation(s)
- Ivanka Miranda de Castro Martins
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil
| | | | - Hélio Amante Miot
- Department of Infectology, Dermatology, Imaging Diagnosis and Radiotherapy, Faculty of Medicine, Universidade Estadual Paulista, Botucatu, SP, Brazil.
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Szewczyk M, Marszałek A, Golusiński P, Niewinski P, Kosińska A, Pazdrowski J, Dańczak-Pazdrowska A, Golusiński W. Does experience affect surgical margins in head and neck basal cell carcinoma? Otolaryngol Pol 2022; 76:1-6. [DOI: 10.5604/01.3001.0015.7117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose: The aim of our study was to evaluate the impact of surgical experience in a high volume head and neck surgery department on basal cell carcinoma margin status.
Methods: A retrospective analysis of 546 patients surgically treated for primary basal cell carcinoma of the head and neck region was done. Resections were performed by 4 specialists with equal experience in head and neck surgery and 4 ENT residents at the same level of surgical training. A margin of 3-5mm was chosen, according to guidelines.
Results: The study consisted of 304 males and 242 females, mean age of 69 (range 26 – 100). Most of the tumors were located on the nose (165 pts; 30,2%) and auricle (119; 21,7%). The most common histological subtype was nodular (119; 21,7%). Tumor size was up to 20mm in 394 cases (72%). Positive surgical margins were found in 112 cases (20,5%). There was no difference in terms of positive surgical margins between residents (19/119 cases; 15,9%) and specialists (93/426; 21,8%; p=0.161).
Conclusions: The results of our study have shown that adequate surgical training in dedicated head and neck surgery department is an efficient factor in obtaining free surgical margins in head and neck basal cell carcinoma.
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Affiliation(s)
- Mateusz Szewczyk
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Andrzej Marszałek
- Zakład Patologii Nowotworów. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Paweł Golusiński
- Kliniczny Oddział Otorynolaryngologii. Uniwersytet Zielonogórski
| | - Patryk Niewinski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Agnieszka Kosińska
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | - Jakub Pazdrowski
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
| | | | - Wojciech Golusiński
- Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej. Uniwersytet Medyczny w Poznaniu. Wielkopolskie Centrum Onkologii
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Kavoussi H, Ebrahimi A, Rezaei M, Najafi F, Zarpoosh M, Kavoussi R. Comparison of Demographic and Clinicopathological Characteristics of Basal Cell Carcinoma on the Nose and Other Sites of the Face: A Cross-Sectional Study. IRANIAN JOURNAL OF OTORHINOLARYNGOLOGY 2021; 33:257-262. [PMID: 34692572 PMCID: PMC8507944 DOI: 10.22038/ijorl.2021.47720.2575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/03/2021] [Indexed: 11/29/2022]
Abstract
Introduction: The clinicopathological characteristics of basal cell carcinoma (BCC) in different areas of the face, including the nose, are important and may be different. Accurate recognition of these characteristics may be necessary for the planning and selection of appropriate treatment. Materials and Methods: This cross-sectional study was conducted on 328 patients (131 females and 197 males) with 371 documented facial BCC in the West of Iran within 2013-2018. The demographic and clinicopathological data of the patients in the nose area were compared with other sites of the face by appropriate statistical methods. Results: Out of 371 lesions, 38.8% of the cases were on the nose, 75.8% were primary lesions, 97.8% had no perineural invasion, 89.2% were nodular, and 65.8% were of nodular clinical and pathologic type, which were the most common variables of patients. It was revealed that early-onset (P<0.001), smaller size (P<0.001), high-risk pathologic type (P=0.01), and recurrent lesions (P=0.013) were significantly higher in the nasal BCC. However, there was no significant difference between BCC in the nose and other sites of the face in terms of gender (P=0.654), high-risk clinical type (P=0.06), and perineural invasion (P=0.275). Conclusion: Considering the nasal site as an important cosmetic unit, more limitation of the nose in performing any procedure, and presence of the more risk factors in the nose than in other areas of the face, the definite treatment of nasal BCC requires special attention, expertise, and experience.
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Affiliation(s)
- Hossein Kavoussi
- Department of Dermatology, Hajdaie Dermatology Clinic, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Ebrahimi
- Department of Dermatology, Hajdaie Dermatology Clinic, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mansour Rezaei
- Family Health Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fariba Najafi
- Department of Dermatology, Hajdaie Dermatology Clinic, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahsa Zarpoosh
- Medical Student, School of Medicine, Students Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Reza Kavoussi
- Physical Practitioner, Kermanshah University of Medical Sciences (KUMS), Kermanshah, Iran
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4
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Barcaui EDO, Carvalho ACP, Valiante PM, Piñeiro-Maceira J, Barcaui CB. High-frequency (22-MHz) ultrasound for assessing the depth of basal cell carcinoma invasion. Skin Res Technol 2021; 27:676-681. [PMID: 33404160 DOI: 10.1111/srt.12999] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/04/2020] [Accepted: 12/05/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND High-frequency ultrasound (HFUS) has been studied in the diagnosis and therapeutic management of basal cell carcinoma (BCC). The accuracy of this method for location of deep margins remains unknown. This study evaluates HFUS for localization of deep surgical margins in BCC. MATERIALS AND METHODS Ultrasound images of 83 lesions from 67 patients with clinical and dermoscopic diagnosis of BCC were compared with histopathological findings. Pearson's correlation coefficient was used to assess the relationship between thickness as measured by HFUS and histopathology. RESULTS A strong correlation between HFUS and histopathological measurements was identified (r = 0.9744, P < .001). HFUS had sensitivity of 96%, specificity of 84%, and accuracy of 91% for measurement of deep tumor margins. Factors affecting tumor measurement on HFUS include marked basophilic degeneration of collagen, presence of peritumoral hypertrophic glands or hair follicles, fibrosis, and dense inflammatory changes related to the tumor itself or to prior procedures. CONCLUSION High-frequency ultrasound was effective in localizing deep tumor margins in BCC. Therefore, we believe that this diagnostic imaging method is important when selecting a therapeutic approach, considering Mohs micrographic surgery, and evaluating the surgical site.
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Nolan G, Kiely A, Totty J, Wormald J, Wade R, Arbyn M, Jain A. Incomplete surgical excision of keratinocyte skin cancers: a systematic review and meta‐analysis*. Br J Dermatol 2020; 184:1033-1044. [PMID: 33131067 DOI: 10.1111/bjd.19660] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Keratinocyte or nonmelanoma skin cancer (NMSC) is the commonest malignancy worldwide. The usual treatment is surgical excision. Current guidelines underestimate incomplete excision rates. OBJECTIVES We aimed to determine the risk of incomplete excision of NMSCs through a systematic review and meta-analysis of primary clinical studies. METHODS A PRISMA-compliant systematic review and meta-analysis was performed using methodology proposed by Cochrane (PROSPERO CRD42019157936). A comprehensive search strategy was applied to MEDLINE, Embase, Scopus, CINAHL, EMCare, Cochrane Library and the grey literature (January 2000-27 November 2019). All studies were included except those on Mohs micrographic surgery, frozen section or biopsies. Abstract screening and data extraction were performed in duplicate. Risk of bias was assessed using a tool for prevalence/incidence studies. The primary outcome was the proportion of incomplete surgical excisions. A random-effects model for pooling of binomial data was used. Differences between proportions were assessed by subgroup meta-analysis and meta-regression, which were presented as risk ratios (RRs). RESULTS Searching identified 3477 records, with 110 studies included, comprising 53 796 patients with 106 832 basal cell carcinomas (BCCs) and 21 569 squamous cell carcinomas (SCCs). The proportion of incomplete excisions for BCC was 11·0% [95% confidence interval (CI) 9·7-12·4] and for SCC 9·4% (95% CI 7·6-11·4). Proportions of incomplete excisions by specialty were: dermatology, BCCs 6·2% and SCCs 4·7%; plastic surgery, BCCs 9·4% and SCCs 8·2%; general practitioners, BCCs 20·4% and SCCs 18·9%. The risk of incomplete excision for general practitioners was four times that of dermatologists for both BCCs (RR 3·9, 95% CI 2·0-7·3) and SCCs (RR 4·8, 95% CI 1·0-22·8). Studies were heterogeneous (I2 = 98%) and at high risk of bias. CONCLUSIONS The proportion of incomplete excisions is higher than previously reported. Excisions performed by specialists may lower the risk of incomplete excision.
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Affiliation(s)
- G.S. Nolan
- Department of Plastic and Reconstructive Surgery Whiston HospitalSt Helens and Knowsley Teaching Hospitals NHS Trust Warrington Road Prescot Merseyside UK
| | - A.L. Kiely
- Department of Plastic and Reconstructive Surgery Queen Elizabeth HospitalUniversity Hospitals Birmingham NHS Trust Edgbaston UK
| | - J.P. Totty
- Department of Plastic and Reconstructive Surgery Hull University Teaching HospitalsCastle Hill Hospital Cottingham East Riding of Yorkshire UK
| | - J.C.R. Wormald
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Department of Plastic and Reconstructive Surgery Stoke Mandeville HospitalBuckinghamshire Healthcare NHS Trust Aylesbury UK
| | - R.G. Wade
- Leeds Institute for Medical Research University of Leeds Leeds UK
- Department of Plastic and Reconstructive Surgery Leeds Teaching Hospitals NHS Trust Leeds UK
| | - M. Arbyn
- Unit of Cancer Epidemiology Belgian Cancer Centre Sciensano Brussels Belgium
| | - A. Jain
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK
- Department of Plastic and Reconstructive Surgery Charing Cross and St Mary’s HospitalsImperial College Healthcare NHS Trust London UK
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Kavoussi R, Kavoussi H, Ebrahimi A, Salari N, Madani SH. Outcome of staged excision with pathologic margin control in high-risk basal cell carcinoma of the head region. An Bras Dermatol 2020; 95:583-588. [PMID: 32711927 PMCID: PMC7563009 DOI: 10.1016/j.abd.2020.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/27/2020] [Indexed: 11/21/2022] Open
Abstract
Background High-risk basal cell carcinoma involves a significant rate of basal cell carcinoma that requires Mohs micrographic surgery for definitive treatment. Staged excision with pathologic margin control is a simple, accessible, and curative procedure suggested for the treatment of high-risk basal cell carcinoma. Objective To evaluate the results of staged excision of high-risk basal cell carcinoma in the head region. Methods This interventional study was performed on patients with high-risk basal cell carcinoma, who underwent staged excision until the margins were free of tumor. Results A total of 122 patients (47 females and 75 males) with mean age of 57.66 ± 9.13 years were recruited in this study. Nasal and nodular types were the most common of both clinical and pathologic forms, respectively. Further, 89.3 % of cases were cured by staged excision after four years of follow-up. There was a significant relationship between treatment outcomes and recurrent lesions, multiplicity of risk factors, long-standing disease, and pathologic type. There was also a significant association between the number of surgical excisions and multiplicity of risk factors, as well as recurrence, location, and size of basal cell carcinoma. Study limitations Lack of magnetic resonance imaging assessment in cases of suspected perineural invasion. Conclusions High-risk basal cell carcinoma had a high cure rate by staged excision. Patients with more risk factors and those with nasal and recurrent basal cell carcinoma required more staged excisions. Failure of treatment is more probable in patients with more risk factors, long-standing lesions, and high-risk pathologic and recurrent basal cell carcinomas.
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Affiliation(s)
- Reza Kavoussi
- Department of Dermatology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Kavoussi
- Department of Dermatology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Ali Ebrahimi
- Department of Dermatology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Hamid Madani
- Department of Pathology, Kermanshah University of Medical Sciences, Kermanshah, Iran
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7
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Kondo RN, Gon ADS, Pontello Junior R. Recurrence rate of basal cell carcinoma in patients submitted to skin flaps or grafts. An Bras Dermatol 2019; 94:442-445. [PMID: 31644617 PMCID: PMC7007034 DOI: 10.1590/abd1806-4841.20198298] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 05/19/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. OBJECTIVES To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. METHODS A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. RESULTS Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. STUDY LIMITATIONS Retrospective nature of the study. CONCLUSION The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.
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Affiliation(s)
- Rogerio Nabor Kondo
- Discipline of Dermatology, Hospital Universitário Regional do Norte do Paraná, Universidade Estadual de Londrina, Paraná, PR, Brazil
| | - Airton dos Santos Gon
- Discipline of Dermatology, Medicine Course, Universidade Estadual de Londrina, Paraná, PR, Brazil
| | - Rubens Pontello Junior
- Discipline of Dermatology, Medicine Course, Universidade Estadual de Londrina, Paraná, PR, Brazil
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Lima JSB, Miola AC, Marques MEA, Miot HA. Patterns of proliferation and apoptosis in different subtypes of basal cell carcinoma, adjacent epidermis, and recurrent forms. An Bras Dermatol 2019; 94:108-110. [PMID: 30726478 PMCID: PMC6360986 DOI: 10.1590/abd1806-4841.20198165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 05/18/2018] [Indexed: 08/17/2023] Open
Affiliation(s)
| | - Anna Carolina Miola
- Program of Pathophysiology in Clinical Medicine, Faculdade de
Medicina, Universidade Estadual Paulista, Botucatu (SP), Brazil
| | | | - Hélio Amante Miot
- Dermatology Course, Department of Dermatology and Radiotherapy,
Faculdade de Medicina, Universidade Estadual Paulista, Botucatu (SP), Brazil
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9
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Godoy CAPD, Neta ALDO, Leão SSDS, Dantas RL, Carvalho VOF, Silva SFD. Evaluation of surgical margins according to the histological type of basal cell carcinoma. An Bras Dermatol 2017; 92:226-230. [PMID: 28538884 PMCID: PMC5429110 DOI: 10.1590/abd1806-4841.20175076] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 12/02/2015] [Indexed: 11/29/2022] Open
Abstract
Basal cell carcinoma is the most common skin cancer in the world. The aim of this
study was to evaluate the surgical margin of basal cell carcinoma and correlate
this with its histologic subtype. A retrospective analysis of pathology
laboratory records from 1990 to 2000 was performed and the following data was
collected: age, sex, race, anatomical location, histological type, and state of
the excision margins in 1,428 histopathological reports of basal cell carcinoma.
Ages ranged from 6 to 99 years, with an average of 57. There was a slight
predominance of lesions in white women patients, and the most common
histological subtype was the nodular, followed by the superficial. The most
common locations were in the head and neck, with highest prevalence appeared in
the nose. Surgical margins revealed a lateral involvement of 20.14% and a deep
involvement of 12.47%. The fibrosing basal cell carcinoma is the histological
type that most often presented positive surgical margins.
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Affiliation(s)
- Charles Antonio Pires de Godoy
- Department of Dermatology, Medical School, Tiradentes University (Unit) - Aracaju, SE, Brazil.,Department of Medical Clinics, University Hospital of the Federal University of Sergipe (HU-UFS), Aracaju, SE, Brazil
| | | | | | - Raul Lima Dantas
- Undergraduate student Medical School, Tiradentes University (Unit) - Aracaju, SE, Brazil
| | | | - Samuel Freire da Silva
- Department of Dermatology, University Hospital of the Federal University of Sergipe (HU-UFS), Aracaju, SE, Brazil
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Wakiyama TP, França MLM, Carvalho LP, Marques MEA, Miot HA, Schmitt JV. Initial basal cell carcinomas diagnosed in the National Campaign for Skin Cancer Prevention are smaller than those identified by the conventional medical referral system. An Bras Dermatol 2017; 92:26-29. [PMID: 28225952 PMCID: PMC5312174 DOI: 10.1590/abd1806-4841.20175605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 02/06/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Basal cell carcinoma is the malignant tumor most often diagnosed in the
National Campaign for Skin Cancer Prevention (NCSCP). Little is known about
the profile of these lesions compared to the profile of lesions diagnosed by
conventional routes of public dermatological care. OBJECTIVE To identify if basal cell carcinomas identified in prevention campaigns and
referred to surgery are smaller than those routinely removed in a same
medical institution. METHODS Cross-sectional study including tumors routed from 2011-2014 campaigns and 84
anatomopathological reports of outpatients. RESULTS The campaigns identified 223 individuals with suspicious lesions among 2,531
examinations (9%), with 116 basal cell carcinomas removed.
Anatomopathological examinations revealed that the primary lesions
identified in the national campaigns were smaller than those referred to
surgery by the conventional routes of public health care (28 [13-50] x 38
[20-113] mm2, p <0.01). On the other hand, after a mean
follow-up of 15.6 ± 10.3 months, 31% of cases identified in campaigns
showed new basal cell carcinoma lesions. STUDY LIMITATIONS Retrospective study and inaccuracies in the measurements of the lesions. CONCLUSIONS The NCSCP promotes an earlier treatment of basal cell carcinomas compared to
patients referred to surgery by the conventional routes of public health
care, which can result in lower morbidity rates and better prognosis.
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Affiliation(s)
- Thweicyka Pinheiro Wakiyama
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) (UNESP) - Botucatu (SP), Brazil
| | - Maria Laura Marconi França
- Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) (UNESP) - Botucatu (SP), Brazil
| | - Larissa Pierri Carvalho
- Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) (UNESP) - Botucatu (SP), Brazil
| | - Mariangela Esther Alencar Marques
- Department of Pathology - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) - Botucatu (SP), Brazil
| | - Hélio Amante Miot
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) (UNESP) - Botucatu (SP), Brazil
| | - Juliano Vilaverde Schmitt
- Department of Dermatology and Radiotherapy - Faculdade de Medicina de Botucatu - Universidade Estadual Paulista "Júlio de Mesquita Filho" (FMB-UNESP) (UNESP) - Botucatu (SP), Brazil
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11
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Mendaçolli PJ, Brianezi G, Schmitt JV, Marques MEA, Miot HA. Nuclear morphometry and chromatin textural characteristics of basal cell carcinoma. An Bras Dermatol 2016; 90:874-8. [PMID: 26734870 PMCID: PMC4689077 DOI: 10.1590/abd1806-4841.20154076] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Accepted: 10/22/2014] [Indexed: 12/19/2022] Open
Abstract
Histological subtypes of basal cell carcinoma have biological, evolutionary
and distinct prognostic behavior. The analysis of characteristics of the
nucleus can provide data on their cellular physiology and behavior. The
authors of this study evaluated nuclear morphological parameters and
textural patterns of chromatin from different subtypes of basal cell
carcinoma: nodular (n=37), superficial (n=28) and sclerodermiform (n=28).
The parameters were compared between neoplasms' subtypes and with
unaffected adjacent basal epithelium. Nuclear area and diameter of
sclerodermiform neoplasms were superior to the other subtypes. Chromatin's
color intensity and fractal dimension were less intense in superficial
subtypes. Nuclear roundness and chromatin's entropy presented lower values
in tumors than in normal epithelium. There was significant correlation
between morphological and textural variables of normal skin and tumors.
Morphometric elements and textural chromatin's homogeneity of basal cell
carcinomas may be related to evolutionary, biological and behavior
particularities related to each histotype.
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12
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Nasal Sinus Tract of Odontogenic Origin: Report of a Case. Case Rep Dent 2015; 2015:813478. [PMID: 26649208 PMCID: PMC4662969 DOI: 10.1155/2015/813478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2015] [Revised: 10/07/2015] [Accepted: 10/20/2015] [Indexed: 11/18/2022] Open
Abstract
Extraoral sinus tract often poses a diagnostic challenge to the clinician owing to its rare occurrence and absence of symptoms. The accurate diagnosis and comprehensive management are inevitable as the aetiology of such lesions is often masked and requires holistic approach. The present case report encompasses the management of an extraoral discharging sinus tract at the base of the right nostril in a chronic smoker. The lesion which was earlier diagnosed to be of nonodontogenic origin persisted even after erratic treatment modalities. Our investigations showed the aetiology of sinus tract to be odontogenic. Initially, a five-step program as recommended by the Agency for Health Care Research and Quality was used for smoking cessation followed by root canal therapy (RCT) and surgical management of the sinus tract. The patient has been under stringent follow-up and no reoccurrence has been noted.
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13
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Vasconcelos L, Melo JC, Miot HA, Marques MEA, Abbade LPF. Invasive head and neck cutaneous squamous cell carcinoma: clinical and histopathological characteristics, frequency of local recurrence and metastasis. An Bras Dermatol 2014; 89:562-8. [PMID: 25054741 PMCID: PMC4148268 DOI: 10.1590/abd1806-4841.20142810] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 07/22/2013] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND squamous cell carcinoma is the second most common type of skin malignancy and
may evolve to regional lymph node and distant metastases. OBJECTIVE The objective of this study was to evaluate patients with head and neck
cutaneous squamous cell carcinoma to identify its clinical and
histopathological characteristics, as well as the frequency of local
recurrence and metastasis. METHODS A retrospective cohort of patients with head and neck cutaneous squamous cell
carcinoma. Inclusion criteria: histopathological confirmation, follow-up for
longer than one year after diagnosis. Exclusion criteria: immunosuppression;
lip and oral cavity squamous cell carcinoma; and non-surgical resection of
the lesion. We evaluated demographic, clinical and anatomopathologic
findings and explored their associations. RESULTS Sixty-one patients with 79 tumors and followed by 4.8±3.0 years were
selected. The average age was 67.1 years, and 63% of tumors had up to two
centimeters. Seven tumors (8.9%) recurred and two of them had positive
margins. Recurrence was associated with higher Broders' grade (p<0.01).
Two patients (3.3%) had regional lymph node metastases. There were no
distant metastases. Seventy tumors were considered to be usual tumors
(89.7%), and 68 (87.2%) were classified as Broders' grade 1 and 2.
Additionally, 64.1% of tumors had a depth of invasion below four
millimeters. Thirteen tumors (16.7%) had positive histological margins. CONCLUSIONS Most patients had good prognosis in the first year of follow-up, confirming
that head and neck cutaneous squamous cell carcinoma has a better prognosis
than squamous cell carcinoma of other regions such as mucosa, oral cavity,
and internal organs.
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Affiliation(s)
- Luiza Vasconcelos
- Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
| | | | - Hélio Amante Miot
- Universidade Estadual Paulista Júlio de Mesquita Filho, Botucatu, SP, Brazil
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Saintes C, Saint-Jean M, Brocard A, Peuvrel L, Renaut JJ, Khammari A, Quéreux G, Dréno B. Development of squamous cell carcinoma into basal cell carcinoma under treatment with Vismodegib. J Eur Acad Dermatol Venereol 2014; 29:1006-9. [PMID: 24980899 DOI: 10.1111/jdv.12526] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 03/17/2014] [Indexed: 01/12/2023]
Abstract
BACKGROUND Basal cell carcinoma (BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC. AIM However, its action on squamous cell carcinoma (SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients. MATERIAL AND METHODS We have described three cases of patients developing SCC during treatment by vismodegib for BCC. RESULTS Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC. DISCUSSION Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway. CONCLUSION In practice, any dissociated response of a BCC to vismodegib should be biopsied.
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Affiliation(s)
- C Saintes
- Skin Cancer Unit, CHU Hôtel Dieu, Nantes, France
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Analysis of selected recurrence risk factors after treatment of head and neck basal cell carcinoma. Postepy Dermatol Alergol 2014; 31:146-51. [PMID: 25097485 PMCID: PMC4112263 DOI: 10.5114/pdia.2014.40959] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 11/18/2013] [Accepted: 12/04/2013] [Indexed: 11/17/2022] Open
Abstract
Introduction Basal cell carcinoma (BCC) is the most common type of non-melanoma malignant skin tumors. Eighty-five percent of all cases are located on the skin of the head and neck. The risk of recurrence after surgery is estimated at 5–15%. Aim To evaluate the selected risk factors for recurrence after surgical treatment of head and neck BCC at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences. Material and methods A retrospective analysis was made of patients treated at the Department of Head and Neck Surgery in the Greater Poland Cancer Centre of the Poznan University of Medical Sciences in 2007–2012 for BCC of the head and neck region. The study covered 312 patients: 198 males (63%) and 114 females (37%), aged 32–96 years. Results In the study group of 312 tumors, recurrence after initial treatment in this Centre was diagnosed in 18 patients (9%), whereas in patients who were previously operated elsewhere, recurrence was found in 22 cases (17%). The nodular type was the most common BCC type in the study group and concerned 175 patients (56%). The most numerous group (114; 37%) in this study group comprised patients with external nose and cheek tumors. Conclusions The importance of preoperative biopsy to assess the histological type as a routine treatment of patients with BCC is essential. Ultrasound evaluation to assess the exact size and depth of tumor invasion should also be implemented.
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Abstract
This article focuses on the surgical treatment of nonmelanoma skin cancers of the head and neck. The risk factors of nonmelanoma skin cancers for recurrence and metastases that are important for choosing the best treatment option are summarized. Surgical treatment options including surgical excision with standard margins, frozen section, staged surgery, and Mohs micrographic surgery are described. Indications, techniques, outcomes, and advantages and disadvantages of each approach are reviewed. Finally, management of incomplete excisions is discussed.
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Nunes DH, FrÖde TS. Quality of Life in Basal Cell Carcinoma Patients in Brazil: A Pilot Cross Sectional Study. Dermatol Surg 2013; 39:620-6. [DOI: 10.1111/dsu.12098] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Resende M, Hercos AC, Miot HA. Corrective eyeglasses and medial canthal basal cell carcinoma: a case-control study. J Eur Acad Dermatol Venereol 2011; 26:828-32. [PMID: 21696453 DOI: 10.1111/j.1468-3083.2011.04163.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Corrective eyeglasses are frequently worn by adults, particularly at older ages. Their lenses and frames provide ultraviolet protection. Medial canthal basal cell carcinomas are infrequent (3-8%), and their relation with the use of corrective glasses was not yet investigated. OBJECTIVES To assess the prevalence of corrective eyeglasses use in individuals with medial canthal basal cell carcinoma. METHODS Case-control study using two controls matched by age, gender, and ethnicity for each case. Cases were patients with medial canthal basal cell carcinoma, and controls were patients with basal cell carcinoma elsewhere on the face. The prevalence of major risk variables was estimated and adjusted by conditional multiple logistic regression. RESULTS Fifty cases and 100 controls were assessed. The mean patient age was 69.7 years, and 54% of the subjects were females. No difference regarding the eyeglasses use or use duration was found between groups. However, when visual defects were separately evaluated, eyeglasses for myopia correction were independently associated with lower risk of medial canthal basal cell carcinoma development (OR=0.26; P=0.03), what can be related to long term local photoprotection. CONCLUSION The use of eyeglasses for myopia correction is associated with lower prevalence of medial cantal basal cell carcinoma. Risk-reducing mechanisms should be elucidated.
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Affiliation(s)
- M Resende
- Departamento de Dermatologia, Faculdade de Medicina de Botucatu, UNESP-Univ Estadual Paulista, Botucatu-SP-Brazil
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