Background: High-frequency ultrasound is a useful method to obtain preoperative information regarding extension of basal cell carcinoma. Its contribution to diagnosis is generally limited, however. Recently, we observed hypersonographic spots in some cases of basal cell carcinoma.
Objective: The present study was performed to determine the diagnostic value of this finding in this type of tumor.
Materials and methods: We conducted a retrospective study of archived sonographic images with a 30- or 15-MHz scanner and histology specimens of a total of 85 lesions, consisting of 29 basal cell carcinomas and 56 melanomas.
Results: The findings were classified into four patterns as follows: Type A, multiple (more than five spots/lesion) hypersonographic spots (14 cases, 48%); Type B, sparse (3-5 spots/lesion) hypersonographic spots (7 cases, 24%); Type C, multiple moderate sonographic spots (3 cases, 10%); and Type D, sparse moderate sonographic spots (5 cases, 17%). Three of 56 melanoma lesions examined as controls showed the Type D pattern, but none showed Type A, B, or C patterns. Histopathologically, these hypersonographic spots in BCCs seemed to correspond to calcification, horn cysts, or clusters of apoptotic cells in the centers of nests of basal cell carcinoma.
Conclusion: Multiple hypersonographic spots might become a useful finding for differential diagnosis between basal cell carcinoma and melanoma.