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Approaches to Perineural, Lymphovascular, and Single-Cell Disease.
Collins, Mary-Katharine; Behshad, Ramona; Maloney, Mary; Pugliano-Mauro, Melissa.
Afiliação
  • Collins MK; Department of Dermatology, University of Pittsburgh, Pittsburgh, PA.
  • Behshad R; Department of Dermatology, Saint Louis University, St. Louis, Missouri.
  • Maloney M; Division of Dermatology, Department of Medicine, University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, Massachusetts.
  • Pugliano-Mauro M; Department of Dermatology, University of Pittsburgh, Pittsburgh, PA.
Dermatol Surg ; 45 Suppl 2: S118-S128, 2019 12.
Article em En | MEDLINE | ID: mdl-31764297
ABSTRACT

BACKGROUND:

Mohs micrographic surgeons should be adept in identifying and managing perineural invasion (PNI), lymphovascular invasion (LVI), and single-cell spread (SCS), features denoting high-risk behavior of basal cell carcinoma (BCC), cutaneous squamous cell carcinoma (cSCC) and microcystic adnexal carcinoma (MAC).

OBJECTIVE:

The purpose of this article is to review the literature and guidelines regarding the diagnosis of PNI, LVI, and SCS in BCC, cSCC, and MAC and examine the role of advanced diagnostic studies, adjuvant therapy, and reconstructive techniques of these high-risk tumors. MATERIALS AND

METHODS:

We performed a literature search including the following terms PNI, LVI, SCS, BCC, cSCC, keratinocyte carcinoma, MAC, sentinel lymph node biopsy, radiation, chemotherapy, and staging. Relevant studies, case reports, and review articles were included, as well as National Comprehensive Cancer Network guidelines.

RESULTS:

Pancytokeratin immunohistochemistry may aid in the diagnosis of high-risk features of BCC and cSCC. Reconstruction of the Mohs defect should be carefully considered to allow for thorough inspection. Radiation therapy should be considered as an adjuvant treatment option for high-risk cSCC and BCC. Close surveillance for recurrence is warranted.

CONCLUSION:

The Mohs surgeon should be competent in identification of high-risk tumors and to understand how best to manage, further treat, and follow these tumors.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Carcinoma Basocelular / Carcinoma de Células Escamosas / Cirurgia de Mohs / Neoplasias de Anexos e de Apêndices Cutâneos Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Dermatol Surg Assunto da revista: DERMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Panamá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Cutâneas / Carcinoma Basocelular / Carcinoma de Células Escamosas / Cirurgia de Mohs / Neoplasias de Anexos e de Apêndices Cutâneos Tipo de estudo: Diagnostic_studies / Guideline / Prognostic_studies Limite: Humans Idioma: En Revista: Dermatol Surg Assunto da revista: DERMATOLOGIA Ano de publicação: 2019 Tipo de documento: Article País de afiliação: Panamá