Clinical usefulness of high-frequency ultrasonography in the monitoring of basal cell carcinoma treatment effects

Magdalena Raszewska-Famielec; Adam Borzêcki; Dorota Krasowska; Grażyna Chodorowska

doi:10.5114/ada.2020.96099

Clinical usefulness of high-frequency ultrasonography in the monitoring of basal cell carcinoma treatment effects

Postepy Dermatol Alergol. 2020 Jun;37(3):364-370. doi: 10.5114/ada.2020.96099. Epub 2020 Jul 16.

Authors

Magdalena Raszewska-Famielec^{1

2}, Adam Borzêcki¹, Dorota Krasowska³, Grażyna Chodorowska³

Affiliations

¹ NZOZ Med-Laser Dermatology Clinic, Lublin, Poland.
² Faculty of Physical Education and Health, University of Physical Education, Biala Podlaska, Poland.
³ Department of Dermatology and Venerology, Medical University of Lublin, Lublin, Poland.

Abstract

Introduction: To date, there has been no consensus either on the method, frequency or total duration of follow-up for patients that have developed a basal cell carcinoma (BCC).

Aim: To evaluate usefulness of high-frequency ultrasound in monitoring patients with BCC, particularly to detect residual disease or early recurrence.

Material and methods: Seventy-eight patients with suspicious lesions of BCC were enrolled in this study. Only patients for whom histologic evaluation confirmed diagnosis of BCC (70) continued the study. The dermatoscopic and ultrasonographic observation started before the treatment. Three control examinations were performed 4, 12 and 24 weeks after the treatment.

Results: A total of 70 basal cell carcinomas were examined in this study. The presence of cancer formation was observed in the margins of removed nodular BCC in 15% (6/40), in another 25% of cases the margin of surgical removal was narrow and was < 0.2 cm (10/40). For 4 of 6 (66%) lesions, in which histopathological examination demonstrated a positive margin, hypo or heteroechogenic, irregularly shaped focal lesions were found in the ultrasonographic examination just under the entrance echo on the first follow-up visit. In 2 other cases of positive margins of the removed BCC, no signs of residual disease were observed in ultrasonographic examination. For patients with a narrow margin of healthy tissues after surgical removal, hypo or heteroechogenic foci located directly under the entrance echo were also observed in the ultrasonographic examination 4 weeks after the surgery, suggesting the presence of cancer formation. Reduction in the suspected area and scar formation were observed on the subsequent visits. It was found that the characteristic feature of residual disease presence is an enlargement of the hypoechogenic area in subsequent ultrasonographic examinations.

Conclusions: The use of high-frequency ultrasonography in the monitoring of patients after surgery can accelerate and improve the diagnosis of residual disease.

Keywords: basal cell carcinoma; dermatoscopy; high-frequency ultrasonography; monitoring of basal cell carcinoma.