Caracterização do padrão de vascularização dos subtipos do carcinoma basocelular: correlação entre ultrassonografia de alta frequência com Doppler (22 MHz) e histopatologia

Abstract

Basal cell carcinoma (BCC) is the most common malignant neoplasm globally, representing 75–90% of non-melanoma skin cancers. Despite its relatively low metastatic potential, BCC can cause significant morbidity due to local invasion. This study aims to evaluate the vascularization patterns of BCC subtypes using high-frequency Doppler ultrasound (22 MHz) and correlate these findings with histopathological subtypes. We conducted a retrospective, cross-sectional analysis of 51 tumors from 46 patients with histopathologically confirmed BCC. Ultrasonographic evaluation included grayscale imaging and Doppler techniques to assess vascularization, tumor size, and echogenic features. Parameters such as intratumoral vessel count, resistance index, tumor diameter, thickness, and echogenic points were analyzed and correlated with histological subtypes (low- vs. high-grade). Key findings reveal that high-grade BCC subtypes exhibit increased tumor diameter, thickness, and vascularization (>3 intratumoral vessels and >50% Doppler area). The presence of ≥7 echogenic points showed a potential association with high-grade subtypes but did not achieve statistical significance. Combined ultrasonographic parameters demonstrated enhanced diagnostic accuracy in differentiating between high- and low-grade tumors. This study underscores the value of high-frequency Doppler ultrasound in stratifying BCC risk, guiding therapeutic decisions, and improving clinical management. Further research to standardize ultrasound settings and validate these findings is recommended.