Line‐field confocal optical coherence tomography of basosquamous carcinoma: a case series with histopathological correlation

Abstract

Background Basosquamous carcinoma (BSC) is a rare and potentially aggressive cutaneous neoplasm combining histopathological features of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Line‐field confocal optical coherence tomography (LC‐OCT) is a new, non‐invasive imaging technique featuring excellent resolution and penetration. To date, studies about the use of LC‐OCT in the BCC and SCC fields are available, but similar investigations are lacking in the BSC field. Objective The goal of the present study was to identify/describe LC‐OCT criteria of BSC. Methods Consecutively enrolled BSCs were imaged with dermoscopy and LC‐OCT prior to surgical excision. Dermoscopic and LC‐OCT images were evaluated, and histopathological slides were reviewed. Results Six BSCs from six patients [four (66.7%) males and two (33.3%) females; mean age 76.5 (62–96) years] were included. Identified LC‐OCT criteria for BSC included BCC‐associated (dermal lobules with millefeuille pattern, dilated vessels, bright cells within the epidermis, bright cells within lobules, stromal stretching, stromal brightness) and SCC‐associated features (acanthosis, hyperkeratosis, disarranged epidermal architecture, broad strands, elastosis and glomerular vessels). Interruption of the dermal–epidermal junction and ulceration represented overlapping criteria. Conclusion Line‐field confocal‐OCT is a new promising technique that may support the non‐invasive recognition of BSC through the simultaneous detection of BCC‐associated and SCC‐associated features. We hypothesize that the use of LC‐OCT might be helpful not only in the diagnostic setting but also in the follow‐up surveillance for an early identification of recurrences. Further larger studies are needed to prove this hypothesis.

Line‐field confocal optical coherence tomography of fibroepithelioma of Pinkus

“…4 Recently, LC-OCT proved to be useful for subtype classification of BCC with a diagnostic accuracy of 90%. [5][6][7] Based on the present findings, LC-OCT clearly identified the main features of FeP, in different imaging modes, in vivo and real time, closely resembling architectural details of histopathology.…”

“…5 After the description of BCC morphological criteria, recent studies investigated the potential diagnostic of LC-OCT to discriminate different BCC subtypes. [6][7][8] Herein, we describe for the first time LC-OCT criteria of FeP and their correlation with histopathology.…”

A case of metastatic basal cell carcinoma treated with carboplatin and paclitaxel

“…Recent introduction of line-field confocal optical coherence tomography for the in-vivo diagnosis of keratinocyte tumors has improved BCC subtype recognition and its aggressive variants like basosquamous carcinoma. Thus, it could serve as a very helpful tool for clinicians even in such cases to overcome this discrepancy [ 1 , 2 ].…”

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“…BSC is a non-melanoma aggressive skin malignancy that histopathologically includes the features of basal cell carcinoma and squamous cell carcinoma [20]. The incidence of BSC was found to be 1.2% and 1.4% respectively in various studies [21,22].…”