Reflectance confocal microscopy as a tool for screening surgical margins of basal cell carcinoma

Teixeira, Danilo Augusto; Rezze, Gisele Gargantini; Pinhal, Maria Aparecida Silva; Paschoal, Francisco Macedo

doi:10.1590/abd1806-4841.20187089

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Communication • An. Bras. Dermatol. 93 (4) • Jul-Aug 2018 • https://doi.org/10.1590/abd1806-4841.20187089 copy

Reflectance confocal microscopy as a tool for screening surgical margins of basal cell carcinoma^* * Work conducted at the Faculdade de Medicina do ABC, Santo André (SP), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

Surgical excision of basal cell carcinoma with minimum margins requires serial assessment of layers by frozen histopathology in the case of Mohs micrographic surgery. Evaluation of presurgical tumor margins by in vivo reflectance confocal microscopy is a potential alternative. We selected 12 basal cell carcinoma lesions that were analyzed by confocal microscopy to define margins. The lesions were excised by Mohs surgery. Six tumors showed negative margins in the first phase of Mohs micrographic surgery. We concluded that reflectance confocal microscopy can be useful in the preoperative definition of basal cell carcinoma margins.

Keywords:
Carcinoma, basal cell; Microscopy, confocal; Mohs surgery

Lesion	BCC Subtype (histology)	Location	Clinical size (mm)	RCM features	Commitment of margins (percentage)	Number of MMS phases
1	Micronodular	Nasal dorsum	4 x 3	Presence of tumor islands, clefts, inflammatory cells and microvasculature in the tumor periphery extending beyond the tumor stromal	Deep and lateral margin (<10%)	2
2	Nodular	LeftCheek	7 x 6	Small tumor islands wrapped in fibrous tissue Scattered inflammatory cells	Lateral margin (<5%)	2
3	Nodular	Left forearm	7 x 7	Tumor islands and clefts	Deepmargin(<5%)	2
4	Micronodular	Right arm	7 x 7	Tumor islands and clefts	Deep margin (<20%)	2
5	Nodular	Chin	8 x 8	Tumor islands and clefts	Deep margin (<30%)	2
6	Nodular	Upper lip	7 x7	Tumor islands, dark silhouettes, scattered inflammatory cells	Free margins	1
7	Micronodular	Left scapula	8 x 7	Tumor islands and clefts	Lateral margin (<5%)	2
8	Micronodular	Right scapula	6 x 5	Tumor islands and clefts	Free Margins	1
9	Micronodular and sclerodermiform	Forehead	6 x 3	Tumor islands and clefts, scattered inflammatory cells and microvasculature	Free margins	1
10	Nodular	Forehead	6 x 5	Tumor islands and clefts, scattered inflammatory cells and microvasculature	Free margins	1
11	Micronodular	Left retroauricular	8 x 8	Small tumor islands wrapped in fibrous tissue	Free margins	1

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E-mail: revista@sbd.org.br

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[1] Mailing Address: Danilo Augusto Teixeira. E-mail: danilocotoh@yahoo.com.br

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Reflectance confocal microscopy as a tool for screening surgical margins of basal cell carcinoma* * Work conducted at the Faculdade de Medicina do ABC, Santo André (SP), Brazil.

Abstract:

Reflectance confocal microscopy as a tool for screening surgical margins of basal cell carcinoma^* * Work conducted at the Faculdade de Medicina do ABC, Santo André (SP), Brazil.