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).
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.
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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