Correspondence |

Value of Preoperative Determination of Skin Tumor Thickness With 20-MHz Ultrasound

Dragan L. Jovanovic, MD, PhD; Vuka Katic, MD, PhD; Braslav Jovanovic, MD
Arch Dermatol. 2005;141(2):269-270. doi:10.1001/archderm.141.2.269.
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Twenty-megahertz ultrasound is a potentially useful noninvasive method for the preoperative determination of tumor dimensions and for defining tumor margins and shape.1 Using 20-MHz ultrasound equipment (Dermascan C; Cortex Technology, Hadsund, Denmark), we examined 35 different types of skin tumors (basal cell carcinoma [n = 12], nevus pigmentosus [n = 9], dysplastic nevus [n = 3], dermatofibroma [n = 3], fibropapilloma [n = 2], seborrheic keratosis [n = 2], malignant melanoma [n = 1], lipofibroma [n = 1], neurofibroma [n = 1], and keratosis actinica [n = 1]) before surgery. The maximal vertical diameter of the tumors was determined by combined A- and B-mode. After ultrasound examination, the tumors were surgically removed and a definite diagnosis was made. Hematoxylin-eosin–stained sections were histopathologically examined to determine the maximal vertical diameter of the tumors using an ocular micrometer. The tumor dimensions were statistically correlated (linear correlation and t test).

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Figure 1.

Tumor shape and definition of tumor margins on histopathologic examination (A) correlated very well with those on the echogram (B). The echogram also includes a peritumoral inflammatory infiltrate. A, Histopathologic features of a basal cell carcinoma (hematoxylin-eosin, original magnification ×200). B, Echogram of the basal cell carcinoma.

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Figure 2.

Strong nonechogenic shadowing in the underlying dermis due to signal attenuation in lesion tissue makes clear visualization of the lower tumor margin impossible. A, Histopathologic features of a dermatofibroma (hematoxylin-eosin, original magnification ×200). B, Echogram of the dermatofibroma.

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