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Ultrasound of Skin Cancer

  • Ximena Wortsman
Chapter

Abstract

This chapter reviews the most common forms of skin cancer, including non-melanoma and melanoma skin cancer, and also reviews the sonographic appearance of Merkel cell carcinoma and dermatofibrosarcoma protuberans. The ultrasound characteristics of benign and malignant lymph nodes are analyzed in order to support the recognition of these entities.

Keywords

Skin cancer ultrasound Nonmelanoma skin cancer ultrasound Melanoma ultrasound Basal cell carcinoma ultrasound Squamous cell carcinoma ultrasound Dermatofibrosarcoma protuberans ultrasound Merkel cell carcinoma ultrasound Malignant lymph node ultrasound Lymph node ultrasound 

References

  1. 1.
    Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol. 2015;151:1081–6.CrossRefPubMedGoogle Scholar
  2. 2.
    American Cancer Society. Cancer facts and figures 2017. Atlanta: American Cancer Society; 2017. http://www.cancer.org/acs/groups/content/@editorial/documents/document/acspc-048738.pdf. Accessed 5 Dec 2017.
  3. 3.
    Lear W, Dahlke E, Murray CA. Basal cell carcinoma: review of epidemiology, pathogenesis, and associated risk factors. J Cutan Med Surg. 2007;11:19–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Kwasniak LA, Garcia-Zuazaga J. Basal cell carcinoma: evidence-based medicine and review of treatment modalities. Int J Dermatol. 2011;50:645–58.CrossRefPubMedGoogle Scholar
  5. 5.
    Wortsman X, Carreño L, Morales C. Skin cancer: the primary tumors. In: Wortsman X, Jemec GBE, editors. Dermatologic ultrasound with clinical and histologic correlations. New York: Springer; 2013. p. 249–82.CrossRefGoogle Scholar
  6. 6.
    MacFarlane D, Shah K, Wysong A, Wortsman X, Humphreys TR. The role of imaging in the management of patients with nonmelanoma skin cancer. J Am Acad Dermatol. 2017;76:579–88.CrossRefPubMedGoogle Scholar
  7. 7.
    Wortsman X, Vergara P, Castro A, Saavedra D, Bobadilla F, Sazunic I, et al. Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin. J Eur Acad Dermatol Venereol. 2015;29:702–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Wortsman X. Sonography of facial cutaneous basal cell carcinoma: a first-line imaging technique. J Ultrasound Med. 2013;32:567–72.CrossRefPubMedGoogle Scholar
  9. 9.
    Vega N, Wortsman X, Navarrete N, Sazunic I. Color Doppler ultrasound supports early diagnosis of mixed high and low risk of recurrence subtypes in the same basal cell carcinoma lesion. Dermatol Surg. 2017.  https://doi.org/10.1097/DSS.0000000000001328. [Epub ahead of print].
  10. 10.
    Bobadilla F, Wortsman X, Muñoz C, Segovia L, Espinoza M, Jemec GB. Pre-surgical high resolution ultrasound of facial basal cell carcinoma: correlation with histology. Cancer Imaging. 2008;8:163–72.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Hernández-Ibáñez C, Blazquez-Sánchez N, Aguilar-Bernier M, Fúnez-Liébana R, Rivas-Ruiz F, de Troya-Martín M. Usefulness of high-frequency ultrasound in the classification of histologic subtypes of primary basal cell carcinoma. Actas Dermosifiliogr. 2017;108:42–51.CrossRefPubMedGoogle Scholar
  12. 12.
    Pasquali P, Freites-Martinez A, Fortuño-Mar A. Ex vivo high-frequency ultrasound: A novel proposal for management of surgical margins in patients with non-melanoma skin cancer. J Am Acad Dermatol. 2016;74:1278–80.CrossRefPubMedGoogle Scholar
  13. 13.
    Barcaui Ede O, Carvalho AC, Valiante PM, Barcaui CB. High-frequency ultrasound associated with dermoscopy in pre-operative evaluation of basal cell carcinoma. An Bras Dermatol. 2014;89:828–31.CrossRefPubMedGoogle Scholar
  14. 14.
    Hernández-Ibáñez C, Aguilar-Bernier M, Fúnez-Liébana R, Del Boz J, Blázquez N, de Troya M. The usefulness of high-resolution ultrasound in detecting invasive disease in recurrent basal cell carcinoma after nonsurgical treatment. Actas Dermosifiliogr. 2014;105:935–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Ruiz ES, Karia PS, Morgan FC, Schmults CD. The positive impact of radiologic imaging on high-stage cutaneous squamous cell carcinoma management. J Am Acad Dermatol. 2017;76:217–25.CrossRefPubMedGoogle Scholar
  16. 16.
    Nazarian LN, Alexander AA, Rawool NM, Kurtz AB, Maguire HC, Mastrangelo MJ. Malignant melanoma: impact of superficial US on management. Radiology. 1996;199:273–7.CrossRefPubMedGoogle Scholar
  17. 17.
    Nazarian LN, Alexander AA, Kurtz AB, Capuzzi DM Jr, Rawool NM, Gilbert KR, Mastrangelo MJ. Superficial melanoma metastases: appearances on gray-scale and color Doppler sonography. AJR Am J Roentgenol. 1998;170:459–63.CrossRefPubMedGoogle Scholar
  18. 18.
    Forsberg F, Ro RJ, Liu JB, Lipcan KJ, Potoczek M, Nazarian LN. Monitoring angiogenesis in human melanoma xenograft model using contrast-enhanced ultrasound imaging. Ultrason Imaging. 2008;30:237–46.CrossRefPubMedGoogle Scholar
  19. 19.
    Catalano O, Caracò C, Mozzillo N, Siani A. Locoregional spread of cutaneous melanoma: sonography findings. AJR Am J Roentgenol. 2010;194:735–45.CrossRefPubMedGoogle Scholar
  20. 20.
    Catalano O, Setola SV, Vallone P, Raso MM, D’Errico AG. Sonography for locoregional staging and follow-up of cutaneous melanoma: how we do it. J Ultrasound Med. 2010;29:791–802.CrossRefPubMedGoogle Scholar
  21. 21.
    Catalano O. Critical analysis of the ultrasonographic criteria for diagnosing lymph node metastasis in patients with cutaneous melanoma: a systematic review. J Ultrasound Med. 2011;30:547–60.CrossRefPubMedGoogle Scholar
  22. 22.
    Catalano O, Voit C, Sandomenico F, Mandato Y, Petrillo M, Franco R, et al. Previously reported sonographic appearances of regional melanoma metastases are not likely due to necrosis. J Ultrasound Med. 2011;30:1041–9.CrossRefPubMedGoogle Scholar
  23. 23.
    Marone U, Catalano O, Caracò C, Anniciello AM, Sandomenico F, Di Monta G, et al. Can high-resolution ultrasound avoid the sentinel lymph-node biopsy procedure in the staging process of patients with stage I-II cutaneous melanoma? Ultraschall Med. 2012;33:E179–85.CrossRefPubMedGoogle Scholar
  24. 24.
    Wortsman X. Sonography of the primary cutaneous melanoma: a review. Radiol Res Pract. 2012;2012:814396.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Crisan M, Crisan D, Sannino G, Lupsor M, Badea R, Amzica F. Ultrasonographic staging of cutaneous malignant tumors: an ultrasonographic depth index. Arch Dermatol Res. 2013;305:305–13.CrossRefPubMedGoogle Scholar
  26. 26.
    Badea R, Crişan M, Lupşor M, Fodor L. Diagnosis and characterization of cutaneous tumors using combined ultrasonographic procedures (conventional and high resolution ultrasonography). Med Ultrason. 2010;12:317–22.PubMedGoogle Scholar
  27. 27.
    Fernández Canedo I, de Troya Martín M, Fúnez Liébana R, Rivas Ruiz F, Blanco Eguren G, Blázquez Sánchez N. Preoperative 15-MHz ultrasound assessment of tumor thickness in malignant melanoma. Actas Dermosifiliogr. 2013;104:227–31.CrossRefPubMedGoogle Scholar
  28. 28.
    Music MM, Hertl K, Kadivec M, Pavlović MD, Hocevar M. Preoperative ultrasound with a 12–15 MHz linear probe reliably differentiates between melanoma thicker and thinner than 1 mm. J Eur Acad Dermatol Venereol. 2010;24:1105–8.PubMedGoogle Scholar
  29. 29.
    Lassau N, Mercier S, Koscielny S, Avril MF, Margulis A, Mamelle G, et al. Prognostic value of high-frequency sonography and color Doppler sonography for the preoperative assessment of melanomas. AJR Am J Roentgenol. 1999;172:457–61.CrossRefPubMedGoogle Scholar
  30. 30.
    Lassau N, Koscielny S, Avril MF, Margulis A, Duvillard P, De Baere T, et al. Prognostic value of angiogenesis evaluated with high-frequency and color Doppler sonography for preoperative assessment of melanomas. AJR Am J Roentgenol. 2002;178:1547–51.CrossRefPubMedGoogle Scholar
  31. 31.
    Lassau N, Spatz A, Avril MF, Tardivon A, Margulis A, Mamelle G, et al. Value of high-frequency US for preoperative assessment of skin tumors. Radiographics. 1997;17:1559–65.CrossRefPubMedGoogle Scholar
  32. 32.
    Voit C, Van Akkooi AC, Schäfer-Hesterberg G, Schoengen A, Kowalczyk K, Roewert JC, et al. Ultrasound morphology criteria predict metastatic disease of the sentinel nodes in patients with melanoma. J Clin Oncol. 2010;28:847–52.CrossRefPubMedGoogle Scholar
  33. 33.
    Llombart B, Serra-Guillén C, Monteagudo C, López Guerrero JA, Sanmartín O. Dermatofibrosarcoma protuberans: a comprehensive review and update on diagnosis and management. Semin Diagn Pathol. 2013;30:13–28.CrossRefPubMedGoogle Scholar
  34. 34.
    Sung TH, Tam AC, Khoo JL. Dermatofibrosarcoma protuberans: a comprehensive review on the spectrum of clinico-radiological presentations. J Med Imaging Radiat Oncol. 2017;61:9–17.CrossRefPubMedGoogle Scholar
  35. 35.
    Bae SH, Lee JY. Imaging features of breast dermatofibrosarcoma protuberans in various modalities including FDG-PET CT. Iran J Radiol. 2016;13:e33916.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Zhang L, Liu QY, Cao Y, Zhong JS, Zhang WD. Dermatofibrosarcoma protuberans: computed tomography and magnetic resonance imaging findings. Medicine (Baltimore). 2015;94:e1001.CrossRefGoogle Scholar
  37. 37.
    Shin YR, Kim JY, Sung MS, Jung JH. Sonographic findings of dermato fibrosarcoma protuberans with pathologic correlation. J Ultrasound Med. 2008;27:269–74.CrossRefPubMedGoogle Scholar
  38. 38.
    Catalano O, Alfageme Roldán F, Scotto di Santolo M, Solivetti FM, Wortsman X. Color Doppler sonography of Merkel cell carcinoma. J Ultrasound Med. 2018;37:285–92.  https://doi.org/10.1002/jum.14329.CrossRefPubMedGoogle Scholar
  39. 39.
    Hernández-Aragüés I, Vázquez-Osorio I, Alfageme F, Ciudad-Blanco C, Casas-Férnandez L, Rodríguez-Blanco MI, Suárez-Fernández R. Skin ultrasound features of Merkel cell carcinoma. J Eur Acad Dermatol Venereol. 2017;31:e315–8.CrossRefPubMedGoogle Scholar
  40. 40.
    Ying M, Bhatia KS, Lee YP, Yuen HY, Ahuja AT. Review of ultrasonography of malignant neck nodes: greyscale, Doppler, contrast enhancement and elastography. Cancer Imaging. 2014;13:658–69.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Vassallo P, Wernecke K, Roos N, Peters PE. Differentiation of benign from malignant superficial lymphadenopathy: the role of high-resolution US. Radiology. 1992;183:215–20.CrossRefPubMedGoogle Scholar
  42. 42.
    Ying M, Ahuja A, Brook F, Metreweli C. Power Doppler sonography of normal cervical lymph nodes. J Ultrasound Med. 2000;19:511–7.CrossRefPubMedGoogle Scholar
  43. 43.
    Dragoni F, Cartoni C, Pescarmona E, Chiarotti F, Puopolo M, Orsi E, et al. The role of high resolution pulsed and color Doppler ultrasound in the differential diagnosis of benign and malignant lymphadenopathy: results of multivariate analysis. Cancer. 1999;85:2485–90.CrossRefPubMedGoogle Scholar
  44. 44.
    Chang DB, Yuan A, Yu CJ, Luh KT, Kuo SH, Yang PC. Differentiation of benign and malignant cervical lymph nodes with color Doppler sonography. AJR Am J Roentgenol. 1994;162:965–8.CrossRefPubMedGoogle Scholar
  45. 45.
    Adibelli ZH, Unal G, Gul E, Uslu F, Kocak U, Abali Y. Differentiation of benign and malignant cervical lymph nodes: value of B-mode and color Doppler sonography. Eur J Radiol. 1998;28:230–4.CrossRefPubMedGoogle Scholar
  46. 46.
    Ying L, Hou Y, Zheng HM, Lin X, Xie ZL, Hu YP. Real-time elastography for the differentiation of benign and malignant superficial lymph nodes: a meta-analysis. Eur J Radiol. 2012;81:2576–84.CrossRefPubMedGoogle Scholar
  47. 47.
    Wortsman X, Azocar P, Bouffard JA. Conditions that can mimic dermatologic diseases. In: Wortsman X, Jemec GBE, editors. Dermatologic ultrasound with clinical and histologic correlations. New York: Springer; 2013. p. 505–69.CrossRefGoogle Scholar
  48. 48.
    Wortsman X, Revuz J, Jemec GBE. Lymph nodes in hidradenitis suppurativa. Dermatology. 2009;219:32–41.CrossRefGoogle Scholar
  49. 49.
    Prativadi R, Dahiya N, Kamaya A, Bhatt S. Chapter 5 ultrasound characteristics of benign vs malignant cervical lymph nodes. Semin Ultrasound CT MR. 2017;38:506–15.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.IDIEPInstitute for Diagnostic Imaging and Research of the Skin and Soft TissuesSantiagoChile
  2. 2.Department of DermatologyUniversidad de ChileSantiagoChile
  3. 3.Department of DermatologyPontificia Universidad Católica de ChileSantiagoChile

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