Department of Oral Diagnosis, Oral and Maxillofacial Pathologist, College of Dentistry, University of Anbar.
Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Anbar, Anbar Province, Iraq.
J Craniofac Surg. 2024;35(2):e204-e208. doi: 10.1097/SCS.0000000000009959. Epub 2024 Jan 22.
Basal cell carcinoma (BCC) is one among the most prevalent malignant neoplasms that has exhibited a notable surge in global incidence over recent decades. This slow-growing malignancy is typified by its localized invasiveness while demonstrating an exceedingly rare metastatic proclivity. It predominantly afflicts the sun-exposed skin of aging individuals, with a heightened predilection for the maxillofacial region. Scraping cytology offers numerous benefits, including the potential for an earlier diagnosis and the absence of scarring, as opposed to a biopsy. The cytodiagnosis of BCC proves to be straightforward with various techniques, making it highly advantageous in an outpatient environment as a swift diagnostic method when planning a surgical excision. Our study sought to scrutinize the clinicopathological facets of BCC within the maxillofacial region. We compared advanced cytological techniques for diagnosis, including scraping, scratching, and imprinting using Papanicolau and Diff-Quick stains. In addition, we evaluated the therapeutic effectiveness of diode lasers operating at wavelengths of 940nm and 980n. A retrospective analysis was undertaken, encompassing facial BCC lesions smaller than 2.5 cm in diameter that underwent treatment through diode laser ablation between September 2021 and August 2023 at Ramadi Teaching Hospital and a private clinic in Ramadi City, Iraq. Among the cohort of 48 patients with BCC, a majority (58%) were 50 years of age or older, with a predominance of males (62%). The mean duration of lesion existence exceeded 4 months. The anatomical region most commonly involved was the middle 1/3 of the face, accounting for 34% of cases. Intriguingly, the therapeutic approach of diode laser ablation yielded exceptional esthetic and functional outcomes, which were consistently observed throughout the follow-up period post-healing. The occurrence of complications following diode laser ablation was relatively infrequent. This investigation revealed that cytological examination is easily conducted, eliminating the need for local anesthesia, saving time, being more cost-effective than a conventional biopsy, and delivering swift diagnoses. The process of smear-taking for cytology is well-tolerated, inflicting minimal trauma or discomfort on the patient. BCC predominantly afflicts elderly males and most frequently affects the middle third of the face. Notably, nodular BCC emerged as the prevailing histological subtype. The use of diode laser ablation exhibited a commendable track record, producing exemplary functional and esthetic outcomes over a 6-month follow-up period.
基底细胞癌(BCC)是最常见的恶性肿瘤之一,在过去几十年中,其全球发病率显著上升。这种生长缓慢的恶性肿瘤以局部侵袭性为特征,同时具有罕见的转移性倾向。它主要影响衰老个体的暴露于阳光的皮肤,特别是面中部。刮片细胞学具有许多优点,包括早期诊断的潜力和避免瘢痕形成,而不是活检。BCC 的细胞学诊断使用各种技术非常简单,因此在门诊环境中作为计划手术切除的快速诊断方法非常有利。我们的研究旨在研究面中部 BCC 的临床病理特征。我们比较了先进的细胞学诊断技术,包括刮片、划痕和印模,使用巴氏染色和 Diff-Quick 染色。此外,我们评估了波长为 940nm 和 980nm 的二极管激光的治疗效果。我们进行了回顾性分析,包括 2021 年 9 月至 2023 年 8 月在拉马迪教学医院和拉马迪市的一家私人诊所接受二极管激光消融治疗的直径小于 2.5cm 的面部 BCC 病变。在 48 名 BCC 患者中,大多数(58%)年龄在 50 岁或以上,男性居多(62%)。病变存在的平均时间超过 4 个月。最常受累的解剖区域是面部的中 1/3,占 34%。有趣的是,二极管激光消融的治疗方法产生了出色的美容和功能结果,在愈合后的随访期间始终得到观察。二极管激光消融后并发症的发生相对较少。这项研究表明,细胞学检查易于进行,无需局部麻醉,节省时间,比传统活检更具成本效益,并能快速诊断。细胞学涂片检查患者耐受性良好,对患者造成的创伤或不适最小。BCC 主要影响老年男性,最常影响面中部。值得注意的是,结节状 BCC 是主要的组织学亚型。二极管激光消融的使用记录良好,在 6 个月的随访期间产生了出色的功能和美容效果。