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Skin cancer: findings and role of high-resolution ultrasound

  • Review Article
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Abstract

Currently available high-resolution transducers allow a detailed ultrasound (US) assessment of skin tumors. US complements clinical examination, dermoscopy, and biopsy in the initial differential diagnosis, surgical planning, locoregional staging, and follow-up of patients with skin malignancies. It is important for dermatologists, skin surgeons, and US operators to be aware of the US imaging findings and to recognize the clinical scenarios where imaging is indicated in the management of skin cancer. The purpose of this review article is to address the most common indications for US in skin oncology and to provide a comprehensive guide to the gray-scale and color-Doppler findings in cutaneous malignant tumors.

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Abbreviations

CM:

Cutaneous melanoma

BCC:

Basal cell carcinoma

DFSP:

Dermatofibrosarcoma protuberans

KS:

Kaposi sarcoma

MCC:

Merkel cell carcinoma

PCL:

Primary cutaneous lymphoma

SCC:

Squamous cell carcinoma

US:

Ultrasound

References

  1. Bard RL (2017) High-frequency ultrasound examination in the diagnosis of skin cancer. Dermatol Clin 35:505–511

    Article  CAS  Google Scholar 

  2. Que SKT, Zwald FO, Schmults CD (2018) Cutaneous squamous cell carcinoma: incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol 78:237–247

    Article  Google Scholar 

  3. Wortsman X, Alfageme F, Roustan G, Arias-Santiago S, Martorell A, Catalano O, Scotto di Santolo M, Zarchi K, Bouer M, Gonzalez C, Bard R, Mandava A, Gaitini D (2016) Guidelines for performing dermatologic ultrasound examinations by the DERMUS Group. J Ultrasound Med 35:577–580

    Article  Google Scholar 

  4. Alfageme Roldán F (2013) Handbook of skin ultrasound. CreateSpace Independent Publishing Platform, Charleston

    Google Scholar 

  5. Alfageme Roldán F (2014) Ultrasound skin imaging. Actas Dermosifiliogr 105:891–899

    Article  Google Scholar 

  6. Kleinerman R, Whang TB, Bard RL, Marmur ES (2012) Ultrasound in dermatology: principles and applications. J Am Acad Dermatol 67:478–487

    Article  Google Scholar 

  7. Wortsman X, Jemec GBE (2013) Dermatologic ultrasound with clinical and histologic correlations, 1st edn. Springer, New York

    Book  Google Scholar 

  8. Wortsman X (2012) Common applications of dermatologic sonography. J Ultrasound Med 31:97–111

    Article  Google Scholar 

  9. Esposito F, Ferrara D, Di Serafino M et al (2018) Classification and ultrasound findings of vascular anomalies in pediatric age: the essential. J Ultrasound. https://doi.org/10.1007/s40477-018-0342-1

    Article  PubMed  PubMed Central  Google Scholar 

  10. Aluja Jaramillo F, Quiasúa Mejía DC, Martínez Ordúz HM et al (2017) Nail unit ultrasound: a complete guide of the nail diseases. J Ultrasound 20:181. https://doi.org/10.1007/s40477-017-0253-6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Elia F, Paolino G, Donati M et al (2016) Ultrasound pattern of a rare skin disease: multiple miliary osteoma cutis. J Ultrasound 19:145. https://doi.org/10.1007/s40477-015-0184-z

    Article  CAS  PubMed  Google Scholar 

  12. Wortsman X (2013) Sonography of facial cutaneous basal cell carcinoma: a first-line imaging technique. J Ultrasound Med 32:567–572

    Article  Google Scholar 

  13. Alfageme F, Salgüero I, Nájera L, Suarez ML, Roustan G (2018) Increased marginal stiffness differentiates infiltrative from noninfiltrative cutaneous basal cell carcinomas in the facial area: a prospective study. J Ultrasound Med 1:1. https://doi.org/10.1002/jum.14880

    Article  Google Scholar 

  14. Keohane SG, Proby CM, Newlands C, Motley RJ, Nasr I, Mohd Mustapa MF, British Association of Dermatologists (Squamous and Basal Cell Carcinoma Guideline Development Groups), Slater DN; Royal College of Pathologists (Skin Cancer Lead) (2018) The new 8th edition of TNM staging and its implications for skin cancer: a review by the British Association of Dermatologists and the Royal College of Pathologists, U.K. Br J Dermatol 179(4):824–828

    Article  CAS  Google Scholar 

  15. Bobadilla F, Wortsman X, Muñoz C, Segovia L, Espinoza M, Jemec GB (2008) Pre-surgical high resolution ultrasound of facial basal cell carcinoma: correlation with histology. Cancer Imaging 8:163–172

    Article  Google Scholar 

  16. MacFarlane D, Shah K, Wysong A, Wortsman X, Humphreys TR (2017) The role of imaging in the management of patients with nonmelanoma skin cancer: diagnostic modalities and applications. J Am Acad Dermatol 76:579–588

    Article  Google Scholar 

  17. Wortsman X, Vergara P, Castro A, Saavedra D, Bobadilla F, Sazunic I, Zemelman V, Wortsman J (2015) Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin. J Eur Acad Dermatol Venereol 29:702–707

    Article  CAS  Google Scholar 

  18. Humphreys TR, Shah K, Wysong A, Lexa F, MacFarlane D (2017) The role of imaging in the management of patients with nonmelanoma skin cancer: when is imaging necessary? J Am Acad Dermatol 76:591–607

    Article  Google Scholar 

  19. Que SKT, Zwald FO, Schmults CD (2018) Cutaneous squamous cell carcinoma: management of advanced and high-stage tumors. J Am Acad Dermatol 78:249–261

    Article  Google Scholar 

  20. Catalano O, Setola SV, Vallone P, Mattace Raso M, Gallipoli D’Errico A (2010) Sonography for locoregional staging and follow-up of cutaneous melanoma: how we do it. J Ultrasound Med 29:791–802

    Article  Google Scholar 

  21. Catalano O, Caracò C, Mozzillo N, Siani A (2010) Locoregional spread of cutaneous melanoma: sonography findings. AJR 194:735–745

    Article  Google Scholar 

  22. Corvino A, Corvino F, Catalano O, Sandomenico F, Petrillo A (2017) The tail and the string sign: new sonographic features of subcutaneous melanoma metastasis. Ultrasound Med Biol 43:370–374

    Article  Google Scholar 

  23. Catalano O, Alfageme Roldán F, Scotto di Santolo M, Solivetti FM, Wortsman X (2018) Color Doppler sonography of Merkel cell carcinoma. J Ultrasound Med 37:285–292. https://doi.org/10.1002/jum.14329

    Article  PubMed  Google Scholar 

  24. Hernández-Aragüés I, Vázquez-Osorio I, Alfageme F, Ciudad-Blanco C, Casas-Férnandez L, Rodríguez-Blanco MI, Suárez-Fernández R (2017) Skin ultrasound features of Merkel cell carcinoma. J Eur Acad Dermatol Venereol 31:e315–e318

    Article  Google Scholar 

  25. Shin YR, Kim JY, Sung MS, Jung JH (2008) Sonographic findings of dermatofibrosarcoma protuberans with pathologic correlation. J Ultrasound Med 27:269–274

    Article  Google Scholar 

  26. Solivetti FM, Elia F, Latini A, Cota C, Cordiali-Fei P, di Carlo A (2011) AIDS-Kaposi Sarcoma and Classic Kaposi Sarcoma: are different ultrasound patterns related to different variants? J Exp Clin Cancer Res 30:40

    Article  Google Scholar 

  27. Carrascosa R, Alfageme F, Roustán G, Suarez MD (2016) Skin ultrasound in Kaposi sarcoma. Actas Dermosifiliogr 107:e19–e22

    Article  CAS  Google Scholar 

  28. Chiou HJ, Chou YH, Chiou SY, Chen WM, Chen W, Wang HK, Chang CY (2005) High-resolution ultrasonography of primary peripheral soft tissue lymphoma. J Ultrasound Med 24:77–86

    Article  Google Scholar 

  29. Mandava A, Koppula V, Wortsman X, Catalano O, Alfageme F (2019) The clinical value of imaging in primary cutaneous lymphomas: role of high resolution ultrasound and PET-CT. Br J Radiol 92:20180904

    Article  Google Scholar 

  30. Hung EHY, Griffith JF, Ng AWH, Lee RKL, Lau DTY, Leung JCS (2014) Ultrasound of musculoskeletal soft-tissue tumors superficial to the investing fascia. AJR 202:W532–W540

    Article  Google Scholar 

  31. Goyal U, Kim Y, Tiwari HA, Witte R, Stea B (2015) A pilot study of ultrasound-guided electronic brachytherapy for skin cancer. J Contemp Brachyther 7:374–380. https://doi.org/10.5114/jcb.2015.55538

    Article  Google Scholar 

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Acknowledgements

The authors are grateful to Alessandra Trocino, librarian at the National Cancer Institute Fondazione Pascale of Naples, Italy, for the bibliographic assistance.

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The authors declare that they did not receive any funding for this study.

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Correspondence to Orlando Catalano.

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The authors declare that they have no conflict of interest.

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This is a review article. The images included are from current clinical practice. Anyway, all procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This is a review article. The images included are from current clinical practice. For retrospective chart reviews, the authors obtained the consent requirement to be waived.

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Catalano, O., Roldán, F.A., Varelli, C. et al. Skin cancer: findings and role of high-resolution ultrasound. J Ultrasound 22, 423–431 (2019). https://doi.org/10.1007/s40477-019-00379-0

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  • DOI: https://doi.org/10.1007/s40477-019-00379-0

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