Abstract
Reflectance confocal microscopy (RCM) images skin at cellular resolution and has shown utility for the diagnosis of nonmelanoma skin cancer in vivo. It has the potential to define lesion margins before surgical therapy.ObjectivesTo investigate the feasibility of RCM in defining the margins of basal cell carcinoma before surgery.MethodsThe margins of 10 lesions were evaluated using RCM. Biopsies of the margins were used to confirm the results. A protocol was constructed to define margins. RCM was used to delineate preoperative surgical margins in 13 patients. Intraoperative frozen biopsy was used to confirm the margins.ResultsIn seven of 10 (70.0%) cases, the margins of the cancer were identified suing RCM. The tumor island was the critical feature in identifying the margins. In 12 of 13 (92.3%) cases, frozen biopsy corroborated that the surgical margins delineated by RCM were clear.ConclusionRCM imaging of the margins is feasible and demonstrates the possibility of preoperative mapping of cancer margins.
Highlights
Reflectance confocal microscopy (RCM) images skin at cellular resolution and has shown utility for the diagnosis of nonmelanoma skin cancer in vivo
In 12 of 13 (92.3%) cases, frozen biopsy corroborated that the surgical margins delineated by RCM were clear
Mohs micrographic surgery (MMS) has been shown to be the most efficacious technique for removal of aggressive high-risk basal cell carcinoma (BCC) located on the mid-face and ears,[2,3] but the technique is labor intensive and time consuming, so there is a need for effective tools for improving and facilitating accurate tumour demarcation in patients with these aggressive skin tumors
Summary
To investigate the feasibility of RCM in defining the margins of basal cell carcinoma before surgery
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