275 Predictors of basal cell carcinoma and implications for follow up in high-risk patients in the VAKCC Trial

Background. Periorbital basal cell carcinoma (BCC) is considered a high risk case because it is associated with high rate of recurrence and complication. Superpulsed CO2laser with intraoperative pathologic assessment could be an alternative and appropriate treatment for periocular lesions where Mohs micrographic surgery is not available.Objective. To evaluate the efficacy of superpulsed CO2laser therapy with intraoperative pathologic assessment on periocular BCC involving eyelash line.Method. This follow-up study was performed on 20 patients with a total of 21 BCC lesions that were pathologically documented. Firstly, debulkation of tumoral mass was done by curettage. Then, irradiation and intraoperative pathologic evaluation were done by concurrent CO2laser. The patients were followed up for a period of 36 months.Results. Out of 21 lesions, the nodular type accounted for 15 (71.4%) lesions, and 12 (57.1%) lesions were seen in the lower lid as the most common clinical type and site involvement. Twenty BCC lesions (95.2%) were treated after one session. Damage to eyelash was seen in 2 (10%) patients, but ectropion and other complications were not seen in any patient.Conclusion. Treatment with superpulsed CO2laser and intraoperative pathologic evaluation for periorbital BCC lesions much close to conjunctiva could be an effective method with minimal complications without major danger of recurrence. This modality can be used with care in the inner canthus and high risk pathologic lesions.

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Risk of a second cutaneous primary melanoma and basal cell carcinoma in patients with a previous primary diagnosis of melanoma: true impact of dermoscopy follow-up in the identification of high-risk persons/ Značaj dermoskopskog praćenja u identifikaciji osoba s visokim rizikom od pojave drugog primarnog kutanog melanoma – prikaz slučaja

Serbian Journal of Dermatology and Venerology ◽

10.2478/v10249-011-0031-y ◽

2010 ◽

Vol 2 (4) ◽

pp. 144-148

Author(s):

Irdina Drljević ◽

Faruk Alendar

Keyword(s):

High Risk ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Family Background ◽

Primary Melanoma ◽

Personal History ◽

Second Primary ◽

Superficial Spreading

Abstract In clinical practice, positive personal history is considered to be as an indication of increased melanoma risk. The thickness of melanoma (Breslow Index) is the most important independent predicting factor of survival for stage I patients. We present a case of a second primary melanoma and basal cell carcinoma in a 48-year-old female patient with personal history of a superficial spreading melanoma located at the dorsal trunk with Breslow’s thickness of 0,5 mm and Clark’s II (stage IA) excised a year before, and a family background of melanoma. We would like to emphasize the benefits of digital dermatoscopy as well as teledermoscopy, and new teledermatology web services, in the follow-up of high-risk patients.

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Provider referral patterns following nephrectomy in high-risk locoregional renal cell carcinoma.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.6_suppl.636 ◽

2020 ◽

Vol 38 (6_suppl) ◽

pp. 636-636

Author(s):

Hannah Elizabeth Dzimitrowicz ◽

Elizabeth Esterberg ◽

LaStella Miles ◽

Giovanni Zanotti ◽

Azah Borham ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

High Risk ◽

Cell Carcinoma ◽

Renal Cell ◽

Regional Lymph Node ◽

Risk Of Recurrence ◽

High Risk Patients ◽

Medical Oncologists ◽

Risk Patients

636 Background: It is unclear whether post-nephrectomy patients with renal cell carcinoma (RCC) in real-world practice settings are typically assessed for recurrence risk post-operatively and whether patients at high risk of recurrence are seen by providers who can evaluate candidacy for adjuvant systemic therapy (AST), clinical trials, or alternative surveillance schedules. Methods: We identified all patients with locoregional RCC who underwent nephrectomy within Duke University Health System between April 1, 2015 and March 31, 2019 via an institutional database. Medical records were reviewed to identify patient characteristics, post-nephrectomy treatment and referrals, and follow up. Patients with tumor stage 3 or higher and tumor grade 2 or higher, regional lymph-node metastasis, or both, were classified as high risk of recurrence. Results: Of 500 patients with locoregional RCC who underwent nephrectomy, 111 (22.2%) had high risk of recurrence (Table). 15 patients with high risk disease (13.5%) were referred to a medical oncologist for discussion of AST. Fourteen of the 15 referrals took place in 2018 or later. 7 of 29 (24.1%) high risk patients were referred for discussion of AST in 2018 and 7 of 9 (77.8%) in 2019. All referrals were made by urologists to medical oncologists. Two patients received AST – one as part of a clinical trial and one node-positive patient received standard-of-care sunitinib. In the cohort of high-risk patients, follow up data was available for 83 patients with median follow up time of 1.16 years; 31 patients (37.4%) developed recurrent disease. Conclusions: Within a single large academic institution, despite increasing numbers of patients with locoregional RCC at high risk of recurrence being referred to medical oncologists after nephrectomy, few patients received AST. These findings highlight the need for continued efforts at identifying effective AST and referring patients most likely to benefit.[Table: see text]

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Primary Cutaneous Carcinosarcoma of the Basal Cell Subtype Should Be Treated as a High-Risk Basal Cell Carcinoma

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475415575233 ◽

2015 ◽

Vol 19 (4) ◽

pp. 407-411 ◽

Cited By ~ 3

Author(s):

Emilie Bourgeault ◽

Jimmy Alain ◽

Eric Gagné

Keyword(s):

High Risk ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Epithelial Component ◽

Mesenchymal Differentiation ◽

Show Evidence ◽

Aggressive Tumors ◽

Indolent Disease

Background: Cutaneous carcinosarcoma is a rare primary tumor of the skin, characterized by biphasic epithelial and mesenchymal differentiation. Objective: Due to the limited number of cases reported, there is no consensus regarding treatment and prognosis. Some authors suggest that cutaneous carcinosarcomas should be viewed as aggressive tumors, with ancillary imaging used to evaluate potential metastatic disease. Other reports demonstrate an indolent disease course, especially with epidermal-type cutaneous carcinosarcomas. Methods: We report a case of cutaneous carcinosarcoma, which we treated with electrodessication and curettage following a shave biopsy. The tumor had an epithelial component resembling a basal cell carcinoma and a fibrosarcomatous stroma. Results: At 1-year follow-up, our patient did not show evidence of recurrence or metastasis. Conclusions: Our case suggests that a cutaneous carcinosarcoma with an epithelial component composed of basal cell carcinoma can be regarded as a high-risk nonmelanoma skin cancer.

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