A systematic review of the incidence of basal cell carcinoma with perineural invasion: conventional pathology versus Mohs micrographic surgery

Hill, Madison J; Hoegler, Karl M.; Zhou, Albert E.; Snow, Chloe R; Khachemoune, Amor

doi:10.1007/s00403-022-02354-y

Cited by 4 publications

(2 citation statements)

References 39 publications

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“…This study reported the presence of PNI in 20.1% of cases, and PCI in 30.2% of cases, the remaining numbers not having PNI or PCI. These findings are significantly increased, with the current literature identifying PNI in approximately 1% of cases [ 34 ], and some reporting higher incidences of up to 23.1% (closer to our data), a finding dependent on the technique used, conventional pathology or Mohs procedure, and also in connection to larger tumors and to the morpheaform subtype [ 35 , 36 , 37 ]. Although such ratios have been reported, PNI still remains an underdiagnosed and under-recognized feature of BCCs [ 38 ].…”

Section: Discussionsupporting

confidence: 88%

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion—Findings and Perspectives

Niculet,

Bobeica,

Onisor

et al. 2023

Life

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Basal cell carcinoma (BCC) is a malignant tumor with a rising incidence and is the beneficiary of several innovative evaluation techniques. Histopathology remains the gold standard for assessment, having the possibility of addressing multiple high-risk factors such as perineural invasion (PNI). The current study included a number of 244 BCC patients and targeted the identification of positive PNI and its suggestive signs, and whether they correlated or not with other high-risk tumor signs. PNI was found in 20.1% of patients, with 30.7% of patients having perineural chronic inflammation (PCI), which is a suggestive sign of PNI. PNI was also found in larger tumors, with deeper Clark levels, in high-risk BCCs and high-grade tumors. PNI and PCI are both important for pathology reporting, aiding in treatment choice and further patient management, with possibly positive outcomes concerning morbidity and mortality.

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Section: Discussionsupporting

confidence: 88%

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion—Findings and Perspectives

Niculet,

Bobeica,

Onisor

et al. 2023

Life

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“…However, it is important to note that one of the patients’ lesions was located on the nasal area. The nose is a favored site for perineural invasion (PNI) in BCC [ 37 , 38 ]. Perineural invasion in BCC is an important pathological finding in which tumor cells invade the spaces surrounding nerves.…”

Section: Discussionmentioning

confidence: 99%

Pilot Study on High-Intensity Focused Ultrasound (HIFU) for Basal Cell Carcinoma: Effectiveness and Safety

Calik,

Sauer,

Woźniak

et al. 2024

JCM

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Background: The rising incidence of Basal Cell Carcinoma (BCC), especially among individuals with significant sun exposure, underscores the need for effective and minimally invasive treatment alternatives. Traditional surgical approaches, while effective, often result in notable cosmetic and functional limitations, particularly for lesions located on the face. This study explores High-Intensity Focused Ultrasound (HIFU) as a promising, non-invasive treatment option that aims to overcome these challenges, potentially revolutionizing BCC treatment by offering a balance between efficacy and cosmetic outcomes. Methods: Our investigation enrolled 8 patients, presenting a total of 15 BCC lesions, treated with a 20 MHz HIFU device. The selection of treatment parameters was precise, utilizing probe depths from 0.8 mm to 2.3 mm and energy settings ranging from 0.7 to 1.3 Joules (J) per pulse, determined by the lesion’s infiltration depth as assessed via pre-procedure ultrasonography. A key component of our methodology included dermatoscopic monitoring, which allowed for detailed observation of the lesions’ response to treatment over time. Patient-reported outcomes and satisfaction levels were systematically recorded, providing insights into the comparative advantages of HIFU. Results: Initial responses after HIFU treatment included whitening and edema, indicative of successful lesion ablation. Early post-treatment observations revealed minimal discomfort and quick recovery, with crust formation resolving within two weeks for most lesions. Over a period of three to six months, patients reported significant improvement, with lesions becoming lighter and blending into the surrounding skin, demonstrating effective and aesthetically pleasing outcomes. Patient satisfaction surveys conducted six months post-treatment revealed high levels of satisfaction, with 75% of participants reporting very high satisfaction due to minimal scarring and the non-invasive nature of the procedure. No recurrences of BCC were noted, attesting to the efficacy of HIFU as a treatment option. Conclusions: The findings from this study confirm that based on dermoscopy analysis, HIFU is a highly effective and patient-preferred non-invasive treatment modality for Basal Cell Carcinoma. HIFU offers a promising alternative to traditional surgical and non-surgical treatments, reducing the cosmetic and functional repercussions associated with BCC management. Given its efficacy, safety, and favorable patient satisfaction scores, HIFU warrants further investigation and consideration for broader clinical application in the treatment of BCC, potentially setting a new standard in dermatologic oncology care. This work represents a pilot study that is the first to describe the use of HIFU in the treatment of BCC.

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S2k guideline basal cell carcinoma of the skin (update 2023)

Lang,

Balermpas,

Bauer

et al. 2024

J Deutsche Derma Gesell

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SummaryBasal cell carcinoma is the most common malignant tumor in the fair‐skinned population and its incidence continues to rise. An update of the S2k guideline with the participation of all specialist societies familiar with the clinical picture and previous literature research is of great importance for the quality of care for affected patients. In addition to epidemiology, diagnostics and histology are discussed. After risk stratification, therapy is divided into topical, systemic and radiation therapy. Surgical removal remains the treatment of first choice in most cases. The approval of anti‐PD1 inhibitors for locally advanced and metastatic tumors has opened up a new option in second‐line therapy (after hedgehog inhibitors).

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A systematic review of the incidence of basal cell carcinoma with perineural invasion: conventional pathology versus Mohs micrographic surgery

Cited by 4 publications

References 39 publications

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion—Findings and Perspectives

Basal Cell Carcinoma Perineural Invasion and Suggestive Signs of Perineural Invasion—Findings and Perspectives

Pilot Study on High-Intensity Focused Ultrasound (HIFU) for Basal Cell Carcinoma: Effectiveness and Safety

S2k guideline basal cell carcinoma of the skin (update 2023)

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