Abstract
Micrographic surgery is mainly used for excising basal cell carcinomas in high-risk body sites. The time-consuming process of frozen histopathology could be potentially accelerated by the application of ex vivo confocal laser scanning microscopy (CM). We examined the margins of 52 excised basal cell carcinomas by means of CM, and compared the results to conventional histological findings. For contrast enhancement, tissues were treated with 10% citric acid. The morphologic features of tumors seen in CM corresponded well to conventional light microscopy. Confocal assessment and light microscopical findings were consistent in 84.6%. If a tumor is clearly detectable by means of CM, the procedure of micrographic surgery can be accelerated. Negative confocal findings have yet to be confirmed by conventional microscopy. Applicability of CM is limited because of an inconsistent image quality that does not allow a reliable detection of small tumor nests. Further research into the handling of the samples and into specific contrast enhancement is necessary for CM to become a widely accepted procedure in micrographic surgery.
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References
Lear W, Dahlke E, Murray CA (2007) Basal cell carcinoma: review of epidemiology, pathogenesis, and associated risk factors. J Cutan Med Surg 11:19–30
Kopke LF, Konz B (1995) Micrographic surgery. A current methodological assessment. Hautarzt 46:607–614. doi:10.1007/s001050050306
Chung VQ, Dwyer PJ, Nehal KS et al (2004) Use of ex vivo confocal laser scanning microscopy during Mohs surgery for nonmelanoma skin cancers. Dermatol Surg 30:1470–1478. doi:10.1111/j.1524-4725.2004.30505.x
Boztepe G, Hohenleutner S, Landthaler M, Hohenleutner U (2004) Munich method of micrographic surgery for basal cell carcinomas: 5-years recurrence rates with life-table analysis. Acta Derm Venereol 84:218–222. doi:10.1080/00015550410025228
Rajadhyaksha M, Menaker G, Flotte T, Dwyer PJ, Gonzales S (2001) Confocal examination of nonmelanoma cancers in thick skin excisions to potentially guide Mohs micrographic surgery without frozen histopathology. J Invest Dermatol 117:1137–1143. doi:10.1046/j.0022-202x.2001.01524.x
Patel YG, Nehal KS, Aranda I, Li Y, Halpern AC, Rajadhyaksha M (2007) Confocal reflectance mosaicing of basal cell carcinomas in Mohs surgical skin excisions. J Biomed Opt 122:034027. doi:10.1117/1.2750294
Tannous Z, Torres A, Gonzalez S (2003) In vivo real-time confocal reflectance microscopy: a noninvasive guide for Mohs micrographic surgery facilitated by aluminium chloride, an excellent contrast enhancer. Dermatol Surg 29:839–846. doi:10.1046/j.1524-4725.2003.29219.x
Al-Arashi MY, Salomatina E, Yaroslavsky AN (2007) Multimodal confocal microscopy for diagnosing nonmelanoma skin cancers. Lasers Surg Med 39:696–705. doi:10.1002/lsm.20578
Gareau DS, Li Y, Huang B, Eastman Z, Nehal KS, Rajadhyaksha M (2008) Confocal mosaicing microscopy in Mohs skin excisions: feasibility of rapid surgical pathology. J Biomed Opt 13:054001. doi:10.1117/1.2981828
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The confocal microscope was loaned by Mavig GmbH, Germany
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Kaeb, S., Landthaler, M. & Hohenleutner, U. Confocal laser scanning microscopy—evaluation of native tissue sections in micrographic surgery. Lasers Med Sci 24, 819–823 (2009). https://doi.org/10.1007/s10103-009-0660-9
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DOI: https://doi.org/10.1007/s10103-009-0660-9