Effects of biopsy‐induced wound healing on residual basal cell and squamous cell carcinomas: rate of tumor regression in excisional specimens

Abstract

Background: Wound healing following a partial biopsy of basal cell (BCC) and squamous cell carcinomas (SCC) may induce tumor regression. Methods: Nonmelanoma skin cancer (NMSC) biopsy and re-excision specimens from 1994 to 2001were reviewed for histologic evidence of scar vs. presence of residual tumor in excision specimens. Regressed and non-regressed tumors were analyzed to assess the influence of anatomic location, biopsy technique (punch vs. shave), histologic subtype of BCC or SCC, time interval between biopsy and excision, and patient age. Results: Nine hundred and ten excisions were performed for transected BCC or SCC, 217 (24%) of which showed scar with no residual tumor. Logistic regression analysis revealed significant differences in the regressed vs. non-regressed subsets. SCCs were more likely to regress than BCCs (40% vs. 20%, respectively, p < 0.00001). Independent of the NMSC type, tumors regressed more often following shave rather than punch biopsy (34% vs.15%, respectively, p < 0.00001), as did tumors on the trunk and extremities compared with head and neck cases (31% vs. 21%, respectively, p < 0.01). Conclusions: In our series, 24% of NMSCs transected on the initial biopsy showed no residual tumor in the excision specimens, implying that some event in the interval between biopsy and excision may lead to the eradication of residual tumor.The exact mechanism is unclear, but wound healing likely plays an important role.

Regression of Sebaceous Carcinoma of the Eyelid after a Small Incisional Biopsy: Report of Two Cases

“…Cases of spontaneous regression without surgical intervention have been reported in retinoblastoma [3] and choroidal melanoma [4]. The underlying mechanisms for this phenomenon are currently being studied [1-7]. We report, to the best of our knowledge, the first 2 cases in the current literature of regressed sebaceous carcinoma (SebCC) after a small incisional biopsy.…”

“…Regression following small incisional biopsy of cutaneous cancer is well known to occur in BCC and SCC [1]. Swetter et al [1] studied regression of nonmelanoma skin cancer after incisional biopsy.…”

“…Regression after incisional biopsy of cutaneous basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) is a well-known phenomenon [1]. This has also been reported for Merkel cell carcinoma [2].…”

Margin Status in Shave Biopsies of Nonmelanoma Skin Cancers: Is It Worth Reporting?

“…10 The discrepancy between the results of that study and our own might be explained by the observation that residual SCC is more likely than BCC to regress following partial biopsy and is, therefore, less likely to be identified on subsequent excision. 11 Although a subset of the biopsies we encounter in our practice have been immediately followed by electrodessication and curettage, most neoplasms are biopsied without definitive treatment immediately following the biopsy; in many cases, we are not provided with information regarding the clinical procedure performed. Some clinicians establish further treatment decisions based on whether the neoplasm was eradicated via biopsy.…”

Acurácia da biópsia incisional por trépano de 2 mm nos tumores palpebrais: estudo comparativo entre um e dois sítios

“…Por isso, tem-se indicado o acompanhamento clínico nos casos não agressivos. (38,48,49) Outras formas de tratamento incluem: (21,30,31,50) • Curetagem e cauterização: pode ser indicada para lesão de baixo risco (primária, pequena, bem definida, histologicamente não agressiva). Não recomendada para tumores no nariz, pregas nasolabiais e palpebrais.…”