Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 18.450
Filtrar
1.
Dermatol Surg ; 49(2): 130-134, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36728062

RESUMO

BACKGROUND: Diagnosis and treatment of basal cell carcinoma (BCC) in the same visit by shave removal may decrease health care spending and promote patient satisfaction. OBJECTIVE: To prospectively evaluate deep shave removal of lesions clinically suspicious for low-risk BCC on the trunk or extremities in immunocompetent patients. MATERIALS AND METHODS: Deep shave removal with the intent to remove the entire tumor was performed from January 2015 to June 2016, and patients were followed prospectively for clinical evidence of tumor recurrence. RESULTS: Seventy-seven lesions were removed from 51 patients, including 29 (37%) superficial and nodular BCCs, 27 (35%) superficial BCCs, 16 (21%) nodular BCCs, and 5 (6%) non-BCCs. Fifteen BCCs (21%) had positive residual margins after deep shave removal, which was significantly more likely to occur in nodular compared with superficial BCCs (odds ratio = 7.8, 95% confidence interval = 1.4-43), and underwent re-excision. Fourteen specimens initially reported to have negative margins after deep shave underwent resectioning, which revealed positive margins in 4 specimens (28.6%). No BCCs have recurred clinically after an average follow-up of 50 months (SE 3.2). CONCLUSION: Consider deep shave removal for low-risk BCCs on the trunk or extremities in immunocompetent patients hoping to avoid a second treatment visit.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Estudos Prospectivos , Recidiva Local de Neoplasia/cirurgia , Carcinoma Basocelular/cirurgia , Carcinoma Basocelular/patologia , Margens de Excisão
3.
Int J Mol Sci ; 24(2)2023 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-36675086

RESUMO

Canonical and non-canonical Wnt signaling pathways are involved in cell differentiation and homeostasis, but also in tumorigenesis. In fact, an exaggerated activation of Wnt signaling may promote tumor growth and invasion. We summarize the most intriguing evidence about the role of Wnt signaling in cutaneous carcinogenesis, in particular in the pathogenesis of non-melanoma skin cancer (NMSC). Wnt signaling is involved in several ways in the development of skin tumors: it may modulate the inflammatory tumor microenvironment, synergize with Sonic Hedgehog pathway in the onset of basal cell carcinoma, and contribute to the progression from precancerous to malignant lesions and promote the epithelial-mesenchymal transition in squamous cell carcinoma. Targeting Wnt pathways may represent an additional efficient approach in the management of patients with NMSC.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Via de Sinalização Wnt , Proteínas Hedgehog , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/genética , Carcinoma Basocelular/patologia , Inflamação , Carcinogênese , Microambiente Tumoral
4.
PeerJ ; 11: e14781, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36710862

RESUMO

Objective: We aim to test whether body mass index (BMI) is causally associated with the risk of basal cell carcinoma (BCC) using Mendelian randomization (MR) analysis. Methods: Single-nucleotide polymorphisms (SNPs) associated with four BMI-related traits were screened via a genome-wide association study (GWAS) with 681,275, 336,107, 454,884, and 461,460 European-descent individuals, respectively. Summary-level data for BCC (17,416 cases and 375,455 controls) were extracted from UK Biobank. An inverse variance weighted (IVW) method was employed as the primary MR analysis. Sensitivity analyses were conducted via MR-Egger regression, heterogeneity test, pleiotropy test, and leave-one-out sensitivity test. The assumption that exposure causes outcome was verified using the MR Steiger test. Meta-analysis was also used to estimate the average genetically predicted effect of BMI on BCC. Results: Two-sample MR analysis showed inverse associations between genetically predicted BMI and BCC risk. Moreover, when exposure and outcome were switched to see if reverse causation was possible, there was no evidence of a cause-and-effect relationship from BCC to BMI. Finally, the meta-analysis also showed a strong negative causal relationship between BMI and BCC. Conclusion: Genetical predicted higher BMI were associated with lower BCC risk. Further research is required to comprehend the mechanisms underlying this putative causative association.


Assuntos
Carcinoma Basocelular , Estudo de Associação Genômica Ampla , Humanos , Análise da Randomização Mendeliana , Índice de Massa Corporal , Causalidade , Carcinoma Basocelular/epidemiologia
5.
Actas dermo-sifiliogr. (Ed. impr.) ; 114(1): 39-48, jan. 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-214474

RESUMO

Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)


Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)


Assuntos
Humanos , Carcinoma Basocelular/terapia , Neoplasias Cutâneas/terapia , Revisões Sistemáticas como Assunto
6.
Actas dermo-sifiliogr. (Ed. impr.) ; 114(1): T39-T48, jan. 2023. tab
Artigo em Inglês | IBECS | ID: ibc-214475

RESUMO

Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)


Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)


Assuntos
Humanos , Carcinoma Basocelular/terapia , Neoplasias Cutâneas/terapia , Revisões Sistemáticas como Assunto
9.
BMJ Case Rep ; 16(1)2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36599494

RESUMO

A man in his 50s presented with an ulcerative lesion within the left axillary fold that had progressively worsened over 18 months. Biopsy revealed an ulcerative basal cell carcinoma (BCC), which was surgically managed. CT chest scans done 7 months later assessed post-treatment of radiotherapy. This revealed pulmonary lesions, which were biopsy-proven metastatic BCC. Sonidegib, a hedgehog signalling inhibitor, was used for first-line treatment. Due to progressive disease, sonidegib was ceased. Cemiplimab, a checkpoint inhibitor, was used as second-line treatment based on a phase II trial demonstrating efficacy in the setting of metastatic BCC. CT reports were initially consistent with response but after 6 months of cemiplimab treatment, repeat CT chest scans revealed a decrease in size of the previously cited pulmonary lesions.This is a rare case of BCC metastases which has limited treatment options. This case provides insight of the patient experience on such treatment.


Assuntos
Carcinoma Basocelular , Neoplasias Pulmonares , Neoplasias Cutâneas , Masculino , Humanos , Neoplasias Cutâneas/patologia , Proteínas Hedgehog , Carcinoma Basocelular/patologia , Piridinas , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/secundário
10.
Acta Derm Venereol ; 103: adv00841, 2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36600530

RESUMO

Basal cell carcinoma is the most prevalent cancer in Caucasians worldwide. The aim of this study was to examine the overall risk of melanoma among patients diagnosed with basal cell carcinoma. This population-based retrospective cohort study included data from January 2010 to December 2018 from the databases of the Clalit Health Maintenance Organization and 2 major pathology laboratories in North District, Israel. The incidence and hazard ratio of melanoma in patients with a diagnosis of basal cell carcinoma were determined. Of 466,700 participants, 51% were women and the mean (standard deviation) follow-up was 6.7 (2.9; range 1-9) years. A total of 3,338 patients were diagnosed with basal cell carcinoma during the study period, 82 of whom subsequently developed melanoma. Patients with basal cell carcinoma had a significantly higher incidence of melanoma than patients without basal cell carcinoma (2.46% vs 0.37%; p < 0.0001). Univariate Cox regression analysis revealed a hazard ratio of 6.6 (95% confidence interval: 3.6-12.1; p < 0.0001) for melanoma in patients with a diagnosis of basal cell carcinoma. In conclusion, a diagnosis of basal cell carcinoma confers a significant risk of melanoma.


Assuntos
Carcinoma Basocelular , Melanoma , Neoplasias Cutâneas , Humanos , Feminino , Masculino , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Estudos Retrospectivos , Estudos de Coortes , Carcinoma Basocelular/epidemiologia , Carcinoma Basocelular/patologia , Melanoma/epidemiologia , Melanoma/patologia , Incidência , Fatores de Risco
12.
Int J Mol Sci ; 24(2)2023 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-36674553

RESUMO

TRPCs (transient receptor potential classical or cation channels) play a crucial role in tumor biology, especially in the Ca2+ homeostasis in cancer cells. TRPC4 is a pH-sensitive member of this family of proteins. As solid tumors exhibit an inversed pH-gradient with lowered extracellular and increased intracellular pH, both contributing to tumor progression, TRPC4 might be a signaling molecule in the altered tumor microenvironment. This is the first study to investigate the expression profiles of TRPC4 in common skin cancers such as basal cell carcinoma (BCC), squamous cell carcinoma (SCC), malignant melanoma (MM) and nevus cell nevi (NCN). We found that all SCCs, NCNs, and MMs show positive TRPC4-expression, while BCCs do only in about half of the analyzed samples. These data render TRPC4 an immunohistochemical marker to distinguish SCC and BCC, and this also gives rise to future studies investigating the role of TRPC4 in tumor progression, and especially metastasis as BCCs very rarely spread and are mostly negative for TRPC4.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Melanoma , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/patologia , Melanoma/genética , Melanoma/patologia , Carcinoma de Células Escamosas/patologia , Concentração de Íons de Hidrogênio , Microambiente Tumoral/genética
13.
Int J Mol Sci ; 24(2)2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36674836

RESUMO

Hedgehog-GLI (HH) signaling plays an essential role in embryogenesis and tissue homeostasis. Aberrant activation of the pathway through mutations or other mechanisms is involved in the development and progression of numerous types of cancer, including basal cell carcinoma, medulloblastoma, melanoma, breast, prostate, hepatocellular and pancreatic carcinomas. Activation of HH signaling sustains proliferation, suppresses cell death signals, enhances invasion and metastasis, deregulates cellular metabolism and promotes angiogenesis and tumor inflammation. Targeted inhibition of the HH pathway has therefore emerged as an attractive therapeutic strategy for the treatment of a wide range of cancers. Currently, the Smoothened (SMO) receptor and the downstream GLI transcriptional factors have been investigated for the development of targeted drugs. Recent studies have revealed that the HH signaling is also involved in tumor immune evasion and poor responses to cancer immunotherapy. Here we focus on the effects of HH signaling on the major cellular components of the adaptive and innate immune systems, and we present recent discoveries elucidating how the immunosuppressive function of the HH pathway is engaged by cancer cells to prevent immune surveillance. In addition, we discuss the future prospect of therapeutic options combining the HH pathway and immune checkpoint inhibitors.


Assuntos
Carcinoma Basocelular , Neoplasias Cerebelares , Neoplasias Cutâneas , Masculino , Humanos , Proteínas Hedgehog/metabolismo , Transdução de Sinais , Carcinoma Basocelular/patologia , Receptor Smoothened/metabolismo , Proteína GLI1 em Dedos de Zinco/metabolismo
14.
Br J Oral Maxillofac Surg ; 61(1): 94-100, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36631333

RESUMO

We aimed to build a model to predict positive margin status after curative excision of facial non-melanoma skin cancer based on known risk factors that contribute to the complexity of the case mix. A pathology output of consecutive histology reports was requested from three oral and maxillofacial units in the south east of England. The dependent variable was a deep margin with peripheral margin clearance at a 0.5 mm threshold. A total of 3354 cases were analysed. Positivity of either the peripheral or deep margin for both squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) was 15.4% at Unit 1, 21.1% at Unit 2, and 15.4% at Unit 3. Predictive models accounting for patient and tumour factors were developed using automated machine learning methods. The champion models demonstrated good discrimination for predicting margin status after excision of BCCs (AUROC = 0.67) and SCCs (AUROC = 0.71). We demonstrate that rates of positive excision margins of facial non-melanoma skin cancer (fNMSC), when adjusted by the risk prediction model, can be used to compare unit performance fairly once variations in tumour factors and patient factors are accounted for.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias Cutâneas , Humanos , Margens de Excisão , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/cirurgia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Face/patologia
15.
Klin Monbl Augenheilkd ; 240(1): 13-23, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36706766

RESUMO

This article aims to present the differential diagnostics of benign and malignant eyelid tumours. The most common malignant eyelid tumour is basal cell carcinoma, followed by squamous cell carcinoma. The common signs of malignity are loss of lashes, ulceration, and infiltration of the lesion. Often the clinical appearance is various and therefore only a histological analysis gives the proper diagnosis. For most tumours, surgical resection is the gold standard of therapy. The reconstruction of the defects should be performed by an experienced oculoplastic surgeon. In malignant tumours that require large safety margins, the defect can be easily very large, and the reconstruction must then be performed with advanced ophthalmic plastic reconstruction techniques.


Assuntos
Carcinoma Basocelular , Neoplasias Palpebrais , Neoplasias Cutâneas , Humanos , Neoplasias Palpebrais/diagnóstico , Neoplasias Palpebrais/cirurgia , Diagnóstico Diferencial , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/diagnóstico , Carcinoma Basocelular/cirurgia
16.
BMC Cancer ; 23(1): 98, 2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36707774

RESUMO

BACKGROUND: To compare the effectiveness of high-resolution dermal ultrasound (US) guided superficial radiotherapy (SRT) to non-image-guided radiotherapy in the treatment of early-stage Non-Melanoma Skin Cancer (NMSC). METHODS: A high-resolution dermal ultrasound (US) image guided form of superficial radiation therapy (designated here as US-SRT) was developed in 2013 where the tumor configuration and depth can be visualized prior to, during, and subsequent to treatments, using a 22 megahertz (MHz) dermal ultrasound (US) with a doppler component. We previously published the results using this technology to treat 2917 early-stage epithelial cancers showing a high local control (LC) rate of 99.3%. We compared these results with similar American studies from a comprehensive literature search used in an article/guideline published by American Society of Radiation Oncology (ASTRO) on curative radiation treatment of basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and squamous cell carcinoma in-situ (SCCIS) lesions from 1988 to 2018. Only U.S. based studies with greater than 100 cases with similar patient/lesion characteristics and stages treated by external beam, electron, or superficial/orthovoltage radiation therapy were included in the criteria for selection. The resultant 4 studies had appropriate comparable cases identified and the data analyzed/calculated with regard to local control. Logistic regression analysis was performed comparing each study to US-SRT individually and collectively with stratification by histology (BCC, SCC, and SCCIS). RESULTS: US-SRT LC was found to be statistically superior to each of the 4 non-image-guided radiation therapy studies individually and collectively (as well as stratified by histology subtype) with p-values ranging from p < 0.0001 to p = 0.0438. CONCLUSIONS: Results of US-SRT in local control were statistically significantly superior across the board versus non-image-guided radiation modalities in treatment of epithelial NMSC and should be considered a new gold standard for treatment of early-stage cutaneous BCC, SCC, and SCCIS.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Neoplasias Cutâneas , Humanos , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/diagnóstico por imagem , Carcinoma Basocelular/radioterapia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/radioterapia , Carcinoma de Células Escamosas/patologia , Ultrassonografia
17.
Med Image Anal ; 84: 102702, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36516556

RESUMO

Although deep learning (DL) has demonstrated impressive diagnostic performance for a variety of computational pathology tasks, this performance often markedly deteriorates on whole slide images (WSI) generated at external test sites. This phenomenon is due in part to domain shift, wherein differences in test-site pre-analytical variables (e.g., slide scanner, staining procedure) result in WSI with notably different visual presentations compared to training data. To ameliorate pre-analytic variances, approaches such as CycleGAN can be used to calibrate visual properties of images between sites, with the intent of improving DL classifier generalizability. In this work, we present a new approach termed Multi-Site Cross-Organ Calibration based Deep Learning (MuSClD) that employs WSIs of an off-target organ for calibration created at the same site as the on-target organ, based off the assumption that cross-organ slides are subjected to a common set of pre-analytical sources of variance. We demonstrate that by using an off-target organ from the test site to calibrate training data, the domain shift between training and testing data can be mitigated. Importantly, this strategy uniquely guards against potential data leakage introduced during calibration, wherein information only available in the testing data is imparted on the training data. We evaluate MuSClD in the context of the automated diagnosis of non-melanoma skin cancer (NMSC). Specifically, we evaluated MuSClD for identifying and distinguishing (a) basal cell carcinoma (BCC), (b) in-situ squamous cell carcinomas (SCC-In Situ), and (c) invasive squamous cell carcinomas (SCC-Invasive), using an Australian (training, n = 85) and a Swiss (held-out testing, n = 352) cohort. Our experiments reveal that MuSCID reduces the Wasserstein distances between sites in terms of color, contrast, and brightness metrics, without imparting noticeable artifacts to training data. The NMSC-subtyping performance is statistically improved as a result of MuSCID in terms of one-vs. rest AUC: BCC (0.92 vs 0.87, p = 0.01), SCC-In Situ (0.87 vs 0.73, p = 0.15) and SCC-Invasive (0.92 vs 0.82, p = 1e-5). Compared to baseline NMSC-subtyping with no calibration, the internal validation results of MuSClD (BCC (0.98), SCC-In Situ (0.92), and SCC-Invasive (0.97)) suggest that while domain shift indeed degrades classification performance, our on-target calibration using off-target tissue can safely compensate for pre-analytical variabilities, while improving the robustness of the model.


Assuntos
Carcinoma Basocelular , Carcinoma de Células Escamosas , Aprendizado Profundo , Neoplasias Cutâneas , Humanos , Austrália , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/patologia
18.
Dermatol Surg ; 49(1): 13-16, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36533789

RESUMO

BACKGROUND: There are limited data on the etiology, clinical characteristics, and optimal treatment of vulvar basal cell carcinoma (BCC). OBJECTIVE: This retrospective review may aid in treatment decisions for vulvar BCC. MATERIALS AND METHODS: A retrospective review of our institutional CoPath database was performed, using search terms to identify cases of vulvar BCCs from 2000 to 2018. RESULTS: A total of 35 cases of vulvar BCC were included. Patient age ranged from 33 to 97 years with a mean age of 70 years. Of the 35 cases, 28 (80%) involved the cutaneous vulva, 6 (17%) involved the suprapubic area, and 1 (3%) involved the clitoris. Most vulvar BCCs were treated by wide local excision (46%) and vulvectomies (37%), with 3 cases treated with Mohs (11%) and 2 with electrodesiccation and curettage (6%). Preoperative tumor sizes were 0.86 cm2 for Mohs, 0.94 cm2 for excision, and 1.54 cm2 for vulvectomy. The mean margins were 3 mm for Mohs, 4.4 mm for wide local excision, and 6 mm for vulvectomy. Most cases (77%) were identified and treated by gynecology. CONCLUSION: Mohs micrographic surgery should be considered for the advantages of being tissue sparing, evaluating the complete peripheral and deep margin, and avoiding the costs and risks of general anesthesia.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Neoplasias Vulvares , Feminino , Humanos , Idoso , Adulto , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Estudos Retrospectivos , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Carcinoma Basocelular/cirurgia , Carcinoma Basocelular/patologia , Cirurgia de Mohs , Vulva/cirurgia , Vulva/patologia , Neoplasias Vulvares/cirurgia , Neoplasias Vulvares/patologia
19.
Dermatol Surg ; 49(1): 1-7, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36533788

RESUMO

BACKGROUND: Histologic perineural invasion (PNI) in basal cell carcinomas (BCC) lacks evidence-based treatment guidelines. OBJECTIVE: Systematically review and analyze treatment outcomes of BCC with histologic PNI (PNBCC). MATERIALS AND METHODS: PubMed, Embase, and Cochrane Reviews were searched through June 25, 2021. Thirteen eligible cohort studies were meta-analyzed. RESULTS: 502 of 713 PNBCC were treated with Mohs Surgery (MMS), wide local excision (WLE), or surgery (MMS or WLE) with adjuvant radiation (Surg + RT). Overall 5-year local control (LC) was 97.2% and cancer-specific survival (CSS) was 99.6%. Surg and Surg + RT did not differ in recurrence (2.1% vs 4.7%; p-value 0.56; RR 1.51 [0.37, 6.20]), LC (97.9% vs 96.2%; p-value 0.19; RR 0.98 [0.96, 1.01]) or CSS (100% vs 99.1%; p-value 0.40; RR 0.99 [0.95, 1.02]). LIMITATIONS: No randomized controlled trials were found. Outcome data were often lacking. CONCLUSION: Overall LC and CSS were high at median 5-year follow-up for surgery alone and Surg + RT. Surgery alone and Surg + RT demonstrated statistically equivalent outcomes. We do not recommend adjuvant radiation therapy for solely histologic PNBCC if clear margins are achieved.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Radioterapia Adjuvante , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologia , Recidiva Local de Neoplasia/cirurgia , Carcinoma Basocelular/radioterapia , Carcinoma Basocelular/cirurgia , Carcinoma Basocelular/patologia , Cirurgia de Mohs
20.
Skin Res Technol ; 29(1): e13250, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36482801

RESUMO

BACKGROUND: Basal cell carcinoma (BCC) is the most common skin cancer, accounting for approximately 80% of nonmelanoma skin cancer diagnoses each year. Among other factors, the staging of BCC is influenced by its measured diameter. Stage 1 BCC is defined as a lesion measuring 2 cm across or less. Of note, there have been increasing publications reporting features of "small-sized" BCCs, which can present smaller than 1 mm. However, few of these studies have characterized features of pigmented small-sized BCC. The application of in-vivo imaging such as dermoscopy and reflectance confocal microscopy (RCM) allows for the non-invasive distinction of these lesions from benign and malignant melanocytic neoplasms, thereby reducing unnecessary biopsies. METHODS: Within one year, three patients presented to Oregon Health and Science University's dermatology clinic with pigmented lesions of concern measuring less than 2 mm that were histologically confirmed as pigmented BCC. We sought to characterize the features of these lesions in a case series with the non-invasive imaging modalities of dermoscopy and RCM. RESULTS: All cases presented clinically as a small, brown, macule on the face. Each of the three cases exhibited differing features on dermoscopy. With the application of RCM, we were able to visualize characteristic BCC features, prompting removal by shave biopsy. CONCLUSION: To our knowledge, no other study has reported dermoscopic and RCM features of a cohort of pigmented BCCs 2 mm in diameter or smaller. We propose to define BCCs of this size as micro-BCCs. The variability of dermoscopic findings observed in our study, combined with the small size of these pigmented lesions, shows the utility of RCM as a non-invasive diagnostic tool for pigmented micro-BCCs.


Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Dermoscopia/métodos , Microscopia Confocal/métodos , Carcinoma Basocelular/patologia , Neoplasias Cutâneas/patologia , Pele/patologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...