Noninvasive monitoring of basal cell carcinomas treated with systemic hedgehog inhibitors: Pseudocysts as a sign of tumor regression - 17/09/14
, Daniela Kulichova, MD, Thomas Ruzicka, MD, Carola Berking, MDAbstract |
Background |
Oral hedgehog inhibitors (HHIs) have shown significant efficacy in the treatment of basal cell carcinoma (BCC). The evaluation of tumor regression has been performed using clinical photography and radiographic scans. Noninvasive imaging techniques, such as reflectance confocal microscopy (RCM) and high-definition optical coherence tomography (HD-OCT), have been shown to be valuable in detecting BCC in the skin.
Objective |
We monitored HHI-treated BCC using RCM and HD-OCT in vivo and correlated morphologic changes seen on imaging to changes in traditional histopathology.
Methods |
Six BCCs in 5 patients receiving HHIs (vismodegib or sonidegib) were examined by RCM and HD-OCT before and during treatment. Characteristic features were compared to histopathologic findings, including immunohistochemical analysis.
Results |
Characteristic features of BCC in RCM and HD-OCT decreased or disappeared completely during HHI treatment. Half of the clinically complete responding tumors still featured tumor residue. Pseudocystic structures (“empty” tumor nests in imaging) and widespread fibrosis (coarse bright fibers) were new findings and could be confirmed by histopathology.
Limitations |
Our study was limited by the number of tumor samples and imaging timepoints.
Conclusion |
Using RCM and HD-OCT, HHI-induced regression of BCC can be visualized noninvasively in the skin. The formation of pseudocysts and fibrosis were characteristic signs of BCC response to HHIs.
Le texte complet de cet article est disponible en PDF.Key words : basal cell carcinoma, hedgehog inhibitor, high-definition optical coherence tomography, noninvasive diagnosis, reflectance confocal microscopy
Plan
| Supported by the Matthias Lackas Foundation and the Dr Helmut Legerlotz Foundation (to Dr Berking). |
|
| Dr Maier has received honoraria and consulting fees from AGFA HealthCare GmbH. Dr Berking has received honoraria and consulting fees from Roche Pharma and Novartis Pharma. The other authors have no conflicts of interest to declare. |
Vol 71 - N° 4
P. 725-730 - octobre 2014 Retour au numéro
Article précédent
- Classifying distinct basal cell carcinoma subtype by means of dermatoscopy and reflectance confocal microscopy
- Caterina Longo, Aimilios Lallas, Athanassios Kyrgidis, Harold Rabinovitz, Elvira Moscarella, Silvana Ciardo, Iris Zalaudek, Margaret Oliviero, Amanda Losi, Salvador Gonzalez, Pascale Guitera, Simonetta Piana, Giuseppe Argenziano, Giovanni Pellacani
- Self-reported pigmentary phenotypes and race are significant but incomplete predictors of Fitzpatrick skin phototype in an ethnically diverse population
- Steven Y. He, Charles E. McCulloch, W. John Boscardin, Mary-Margaret Chren, Eleni Linos, Sarah T. Arron
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?