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Dermatologic Surgery : Official... Apr 2020Pathologists sometimes include commentary on margin involvement in shave biopsy reports of keratinocyte carcinoma (KC). This practice can lead to confusion regarding the... (Review)
Review
BACKGROUND
Pathologists sometimes include commentary on margin involvement in shave biopsy reports of keratinocyte carcinoma (KC). This practice can lead to confusion regarding the need for further treatment. There is limited literature evaluating the reliability of reported histologic margin status in shave biopsies of KC.
OBJECTIVE
To evaluate the negative predictive value (NPV) of reported clear shave biopsy margins in basal and squamous cell carcinomas to determine whether this assessment is a reliable predictor of complete tumor removal.
METHODS
A literature review was performed using the PubMed database. The data were compiled, NPVs were calculated by the tumor subgroup, and a statistical analysis was performed.
RESULTS
Four studies met inclusion criteria. Two hundred twenty-one KCs were identified (n = 221). All specimens had negative-reported histologic margins (39 squamous cell carcinoma [SCC] and 182 BCC). Fifty-five cases initially noted to have negative margins on biopsy were found to have residual tumor on subsequent analysis: 5 SCC and 50 BCC, translating to 12.8% of all SCC (5/39) and 27.5% for BCC (50/182). Negative predictive values were found to be 75.1% for all KCs, 87.2% for SCC, and 72.5% for BCC.
CONCLUSION
Negative histologic margin status on shave biopsy specimens of KC has a poor NPV and is an inadequate predictor for complete tumor removal.
Topics: Biopsy; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Keratinocytes; Margins of Excision; Predictive Value of Tests; Reproducibility of Results; Skin; Skin Neoplasms
PubMed: 31567613
DOI: 10.1097/DSS.0000000000002171 -
Der Pathologe Jan 2002Sweat gland carcinomas represent a group of morphological heterogeneous tumors with clear differences regarding clinical course and prognosis. The most relevant and...
Sweat gland carcinomas represent a group of morphological heterogeneous tumors with clear differences regarding clinical course and prognosis. The most relevant and accepted entities are described clinically and histopathologically with special reference to the differentiation from benign adnexal tumors. Carcinomas arising from preexisting benign adnexal tumors such as spiradenocarcinoma, cylindrocarcinoma, malignant mixed tumors of the skin are easily recognized. To establish the diagnosis of microcystic adnexal carcinoma or aggressive digital papillary adenocarcinoma can be more difficult, because these carcinomas do not show cytological criteria for malignancy and may therefore resemble benign adnexal tumors especially in small specimens.
Topics: Adenocarcinoma; Carcinoma; Diagnosis, Differential; Eccrine Glands; Humans; Skin Neoplasms; Sweat Gland Neoplasms
PubMed: 11974507
DOI: 10.1007/s00292-001-0516-y -
British Journal of Cancer Feb 2000Tissue from 54 histologically-identified basal cell carcinomas of the skin was obtained at surgery and assayed using a combination of functional and immunochemical... (Comparative Study)
Comparative Study
Tissue from 54 histologically-identified basal cell carcinomas of the skin was obtained at surgery and assayed using a combination of functional and immunochemical procedures for matrix metalloproteinases (MMPs) with collagenolytic activity and for MMPs with gelatinolytic activity. Collagenolytic enzymes included MMP-1 (interstitial collagenase), MMP-8 (neutrophil collagenase) and MMP-13 (collagenase-3). Gelatinolytic enzymes included MMP-2 (72-kDa gelatinase A/type IV collagenase) and MMP-9 (92-kDa gelatinase B/type IV collagenase). Inhibitors of MMP activity including tissue inhibitor of metalloproteinases-1 and -2 (TIMP-1 and TIMP-2) were also assessed. All three collagenases and both gelatinases were detected immunochemically. MMP-1 appeared to be responsible for most of the functional collagenolytic activity while gelatinolytic activity reflected both MMP-2 and MMP-9. MMP inhibitor activity was also present, and appeared, based on immunochemical procedures, to reflect the presence of TIMP-1 but not TIMP-2. As a group, tumours identified as having aggressive-growth histologic patterns were not distinguishable from basal cell carcinomas with less aggressive-growth histologic patterns. In normal skin, the same MMPs were detected by immunochemical means. However, only low to undetectable levels of collagenolytic and gelatinolytic activities were present. In contrast, MMP inhibitor activity was comparable to that seen in tumour tissue. In previous studies we have shown that exposure of normal skin to epidermal growth factor in organ culture induces MMP up-regulation and activation. This treatment concomitantly induces stromal invasion by the epithelium (Varani et al (1995) Am J Pathol 146: 210-217; Zeigler et al (1996b) Invasion Metastasis 16: 11-18). Taken together with these previous data, the present findings allow us to conclude that the same profile of MMP/MMP inhibitors that is associated with stromal invasion in the organ culture model is expressed endogenously in basal cell carcinomas of skin.
Topics: Blotting, Western; Carcinoma, Basal Cell; Caseins; Collagen; Enzyme Inhibitors; Gelatin; Humans; Hydrolysis; Immunohistochemistry; Matrix Metalloproteinase Inhibitors; Matrix Metalloproteinases; Skin; Skin Neoplasms
PubMed: 10682680
DOI: 10.1054/bjoc.1999.0978 -
Archives of Dermatological Research Sep 2018Chondrodermatitis nodularis helicis (CNH) is a benign auricular disease whose differentiation with nonpigmented tumors is mandatory. Clinical characteristics of CNH are... (Observational Study)
Observational Study
Chondrodermatitis nodularis helicis (CNH) is a benign auricular disease whose differentiation with nonpigmented tumors is mandatory. Clinical characteristics of CNH are well known, but there is no information about the dermoscopic features that could help differentiate CNH from squamous cell carcinoma and other non-melanoma skin cancers. To describe the dermoscopic appearance of CNH and to formulate a differential diagnostic model, we conducted a retrospective, single center, observational dermoscopic study on a sample of 189 biopsy-proven lesions: 25 CNH; 26 squamous cell carcinomas; 62 basal cell carcinomas and 76 other benign and malignant tumors. Univariate and multivariate analyses were conducted by logistic regression. The most significant dermoscopic finding for CNH was a peculiar global configuration (daisy pattern), consisting of white thick lines, radially arranged, converging to a central rounded yellow/brown clod (an erosion covered by keratin or sero-crust). This pattern achieved 92 and 98% of specificity for discriminating CNH with squamous cell carcinoma and basal cell carcinoma, respectively. In conclusion, dermoscopy is valuable for the diagnosis of CNH as a first screening tool because of a consistent global dermoscopic configuration (daisy pattern), consisting of radially arranged white thick lines surrounding a central rounded yellow/brown clod.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cartilage Diseases; Dermatitis; Dermoscopy; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Prognosis; Retrospective Studies; Sensitivity and Specificity; Skin; Skin Neoplasms
PubMed: 29926164
DOI: 10.1007/s00403-018-1844-6 -
Journal of Cutaneous Medicine and... 2015Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma, represents the most common malignancy.
BACKGROUND
Non-melanoma skin cancer (NMSC), including basal and squamous cell carcinoma, represents the most common malignancy.
OBJECTIVE
The aim of this document is to provide guidance to Canadian health care practitioners on NMSC management.
METHODS
After conducting a literature review, the group developed recommendations for prevention, management, and treatment of basal cell carcinomas, squamous cell carcinomas, and actinic keratoses. These tumour types are considered separately in the accompanying articles. The Grading of Recommendations Assessment, Development and Evaluation system was used to assign strength to each recommendation.
RESULTS
This introduction describes the scope and structure of the guidelines and the methods used to develop them. The epidemiology of NMSC is reviewed, as are the pathophysiologic changes occurring with damage to the skin, which lead to the formation of actinic keratoses and invasive squamous or basal cell carcinomas.
CONCLUSIONS
This introduction describes the need for primary prevention and offers an overview of treatment options that are discussed in later chapters of the guidelines.
Topics: Canada; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Keratosis, Actinic; Skin; Skin Neoplasms
PubMed: 26016676
DOI: 10.1177/1203475415588652 -
The American Journal of Dermatopathology May 2013Pilomatrixoma is a common benign neoplasm of children and young adults with a female predilection. In contrast, its malignant counterpart, pilomatrix carcinoma is a rare... (Review)
Review
Pilomatrixoma is a common benign neoplasm of children and young adults with a female predilection. In contrast, its malignant counterpart, pilomatrix carcinoma is a rare neoplasm of older adults with a male preponderance. Pilomatrix carcinomas are locally aggressive with a tendency to recur. We report a case of a 44-year-old male who presented with an enlarging soft tissue tumor on the right upper back. Histology revealed an asymmetric, poorly circumscribed, lobulated neoplasm located deeply in the dermis with infiltration into the underlying subcutaneous tissue. The tumor was comprised of basaloid cells containing vesicular nuclei, prominent nucleoli, scant cytoplasm, and brisk mitotic activity. A focus of basaloid cells transitioning to shadow cells with central keratinized material and tumor necrosis was also present. The diagnosis of a pilomatrix carcinoma was rendered. Considering the infiltrative nature of this neoplasm with perineural and intramuscular invasion, the patient underwent 3 surgical excisions before it was completely removed.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Carcinoma; Child; Child, Preschool; Female; Hair Diseases; Humans; Male; Middle Aged; Necrosis; Neoplasm Invasiveness; Predictive Value of Tests; Reoperation; Skin; Skin Neoplasms; Treatment Outcome; Young Adult
PubMed: 23221469
DOI: 10.1097/DAD.0b013e318274b7da -
ACS Sensors Apr 2022Cancer cells undergo unscheduled proliferation resulting from dysregulation of the cell cycle, and hence, evaluation in tumor is of keen interest to examine the...
Cancer cells undergo unscheduled proliferation resulting from dysregulation of the cell cycle, and hence, evaluation in tumor is of keen interest to examine the invasiveness and recurrence of cancer in the lesion. Molecular probes capable of discriminating actively growing tumor from resting ones remain unexplored despite their vast importance. Here, we describe a novel strategy to visualize invasive areas in tumor with a fluorescence probe that implements synergistic fluorescence response toward the slightly acidic environment of tumor and an ATP-abundant nature of actively growing cells. The probe has been designed for ultrafast detection of ATP with high specificity. We demonstrate its utility in visualizing invasive areas in tumor by distinguishing basal cell carcinomas and squamous cell carcinomas at their early stages by two-photon microscopy.
Topics: Adenosine Triphosphate; Carcinoma, Squamous Cell; Humans; Protons; Skin; Skin Neoplasms
PubMed: 35353484
DOI: 10.1021/acssensors.1c02712 -
Cancer Apr 1978Fifty-eight patients with clinical inflammatory breast carcinoma and 15 patients with "occult" inflammatory cancer (dermal lymphatic carcinomatosis without clinical...
Fifty-eight patients with clinical inflammatory breast carcinoma and 15 patients with "occult" inflammatory cancer (dermal lymphatic carcinomatosis without clinical inflammation) are grouped and reviewed to determine whether diagnosis is pathologic or clinical. All cases represent a retrospective study of records from the Ellis Fischel State Cancer Hospital, Columbia, Missouri. Lesions of clinically apparent and occult inflammatory carcinoma demonstrate similar gross and microscopic growth patterns, histologic types, axillary involvement and early widespread metastases. Regardless of pathologic evidence of dermal lymphatic tumor, patients with clinical inflammation had rapid deterioration. Cases with only a pathological diagnosis were slightly less fulminant in progression. Either clinical or pathologic criteria justify use of the term "inflammatory breast carcinoma" to indicate short-term prognosis despite available treatment.
Topics: Adult; Aged; Breast Neoplasms; Carcinoma; Female; Humans; Lymphatic Metastasis; Lymphoid Tissue; Middle Aged; Neoplasm Invasiveness; Prognosis; Skin
PubMed: 639015
DOI: 10.1002/1097-0142(197804)41:4<1595::aid-cncr2820410450>3.0.co;2-y -
Dermatologic Surgery : Official... Nov 2000Sclerosing basal cell carcinoma (S-BCC) is characterized by an abundant stroma. There is evidence that some tumor cells secrete cytokines that are mitogenic for stromal...
Increased glycosaminoglycans production in sclerosing basal cell carcinoma-derived fibroblasts and stimulation of normal skin fibroblast glycosaminoglycans production by a cytokine-derived from sclerosing basal cell carcinoma.
Sclerosing basal cell carcinoma (S-BCC) is characterized by an abundant stroma. There is evidence that some tumor cells secrete cytokines that are mitogenic for stromal fibroblasts (FBs). From this study we report increased glycosaminoglycan (GAG) production by cultures of S-BCC FBs in comparison to cultures of nodular BCC (N-BCC) FBs and normal skin FBs. GAG production was measured by cetylpyridinium chloride precipitation of incorporated [3H]-glucosamine. The sclerosing BCC FBs demonstrated a significant increase in production of GAG over control FBs (P <.001) and over N-BCC FBs (P<.001). Values reported as a mean percentage +/- SEM for GAG production by S-BCC over control normal skin FBs are 359+/-28 and over N-BCC FBs are 266+/-27. In additional experiments, cell extract dilutions from S-BCC tumor, normal dermis, and normal epidermis were incubated with cultures of normal skin FBs. S-BCC-conditioned media was also incubated with normal FBs and GAG production was measured. For both S-BCC extracts and conditioned media, a dose response curve was established showing increased GAG production by normal FBs in relation to increasing the concentration of S-BCC extract or conditioned media. When S-BCC extract was added to normal FBs there was increased GAG production in comparison to normal FBs incubated with dermal or epidermal extracts (P<.001) for both. Two growth factors, transforming growth factor-beta (TGF-beta) and platelet-derived growth factor (PDGF), already known to be mitogenic for FBs, were incubated with N-BCC and normal FBs in an effort to elucidate the potential cytokine(s) released by S-BCC, causing increased GAG production by surrounding FBs. Neither of these cytokines proved to be effective in promoting a significant increase in GAG production. Our findings support the hypothesis that BCCs release factors that alter stromal FB production of GAG.
Topics: Carcinoma, Basal Cell; Cells, Cultured; Cytokines; Fibroblasts; Glycosaminoglycans; Humans; Sclerosis; Skin; Skin Neoplasms; Tumor Cells, Cultured
PubMed: 11096389
DOI: 10.1046/j.1524-4725.2000.0260111029.x -
Plastic and Reconstructive Surgery Sep 2018After studying this article, the participant should be able to: 1. Characterize basal and squamous cell carcinomas as low or high risk based on size, location,...
LEARNING OBJECTIVES
After studying this article, the participant should be able to: 1. Characterize basal and squamous cell carcinomas as low or high risk based on size, location, histology, and clinical features. 2. Understand appropriate surgical margins in low- and high-risk lesions, and other management options, including Mohs micrographic surgery, electrodissection and curettage, topical agents, cryotherapy, photodynamic therapy, and radiation therapy. 3. Discuss adjuvant therapies for locally advanced and metastatic disease, including radiation therapy, chemotherapy, and targeted therapies such as hedgehog pathway inhibitors. 4. Educate patients on preventive measures such as skin examinations, sun protection, oral retinoids, and oral nicotinamide (vitamin B3). 5. Devise a reconstructive plan once clear oncologic margins are obtained.
SUMMARY
With the growing incidence of basal and squamous cell carcinoma, there is an increasing demand for appropriate oncologic management and aesthetic reconstruction. The goal of this CME article is to provide a foundation of knowledge to accurately diagnose, stage, and treat nonmelanoma skin cancers. In addition, it provides the practicing plastic surgeon alternate tools for managing these skin lesions, including topical agents, destructive therapies, and radiation therapy. Lastly, reconstructive plans for selected soft-tissue defects are discussed.
Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Combined Modality Therapy; Dermatologic Surgical Procedures; Humans; Neoplasm Recurrence, Local; Plastic Surgery Procedures; Skin; Skin Neoplasms
PubMed: 30148788
DOI: 10.1097/PRS.0000000000004696