Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin

Abstract

The presence and count of hyperechoic spots within BCC lesions may help predicting the high risk of recurrence histologic subtypes.

Sonographic Characteristics of Apocrine Nodular Hidradenoma of the Skin

“…However, in our experience, these subtypes also show the classic hyperechoic spots within the hypoechoic solid component of the tumor that have been reported for BCC . These hyperechoic spots within BCCs seem to be good predictors of the BCC subtypes with a high or low risk of recurrence . The rest of the BCC subtypes, squamous cell carcinomas and melanomas, mostly present as hypoechoic solid structures with variable degrees of vascularity and no cystic areas or septa.…”

“…23 These hyperechoic spots within BCCs seem to be good predictors of the BCC subtypes with a high or low risk of recurrence. 24 The rest of the BCC subtypes, squamous cell carcinomas and melanomas, mostly present as hypoechoic solid structures with variable degrees of vascularity and no cystic areas or septa. 16,17,25 From the sonographic perspective, the latter signs plus the previously mentioned sonographic features of apocrine nodular hidradenoma can support the differential diagnosis with common cystic cutaneous lesions that show hypoechoic keratinous content such as epidermal cysts.…”

Color Doppler Sonography of Cutaneous Juvenile Xanthogranuloma With Clinical and Histologic Correlations

“…5 Basal cell carcinomas sonographically differ from juvenile xanthogranuloma in their usual presence of hyperechoic spots within the hypoechoic lesion. 6,7 Additionally, the sum of the clinical and sonographic data in juvenile xanthogranuloma may also be useful in the monitoring of nonsurgical lesions by potentially providing earlier and more detailed information.…”

“…Hair matrix–derived tumors such as pilomatrixomas commonly present a different sonographic pattern characterized by a hypoechoic rim and hyperechoic center with hyperechoic spots due to calcium deposits, which may also generate a posterior acoustic shadowing artifact 5 . Basal cell carcinomas sonographically differ from juvenile xanthogranuloma in their usual presence of hyperechoic spots within the hypoechoic lesion 6 , 7 …”

Ultrasound Diagnosis of Infiltrative Versus Noninfiltrative Subtypes of Cutaneous Basal Cell Carcinoma

“…The high-risk-of-recurrence BCC subtypes were micronodular, sclerosing, infiltrating, morpheiform, and metatypical, and the lowrisk-of-recurrence BCC subtypes were macronodular, superficial, adenoid cystic, and Pinkus fibroepithelioma subtypes. 2 This difference in the methods is relevant because the articles do not use similar histologic definitions of the tumoral aggressiveness. Thus, the discrimination of infiltrative and noninfiltrative subtypes according to one of the characteristics of tumors such as the histologic appearance of the borders may be valid; however, this could not be comparable with the categorization by histologic high-and low-risk-of-recurrence subtypes.…”