Korean J Radiol.  2020 Mar;21(3):325-331. 10.3348/kjr.2019.0508.

Magnetic Resonance Imaging Findings Differentiating Cutaneous Basal Cell Carcinoma from Squamous Cell Carcinoma in the Head and Neck Region

• Kawaguchi
• Kato H
• Tomita H
• Hara A
• Suzui N
• Miyazaki T
• Matsuyama
• Seishima M
• Matsuo M

• KMID: 2470756
• DOI: http://doi.org/10.3348/kjr.2019.0508

Abstract

OBJECTIVE
This study aimed to evaluate the efficacy of magnetic resonance (MR) imaging in differentiating between cutaneous basal cell carcinoma (cBCC) and cutaneous squamous cell carcinoma (cSCC) in the head and neck region.
MATERIALS AND METHODS
Among patients with cutaneous head and neck cancers, 14 with primary cBCCs and 15 with primary cSCCs with a histologic tumor height of ≥ 4 mm underwent MR examinations; the findings were then examined for correlations.
RESULTS
cBCCs (71%) occurred more frequently on the nose than cSCCs (13%) (p < 0.01). The maximum diameter (23.5 ± 7.2 mm vs. 12.7 ± 4.5 mm; p < 0.01) and diameter-to-height ratio (2.8 ± 0.9 vs. 1.7 ± 0.4; p < 0.01) were significantly greater in cSCCs than in cBCCs. Superficial ulcer formation (67% vs. 21%; p < 0.05), protrusion into the subcutaneous tissue (60% vs. 21%; p < 0.05), ill-demarcated deep tumor margins (60% vs. 7%; p < 0.01), and peritumoral fat stranding (93% vs. 7%; p < 0.01) were more frequently observed in cSCCs than in cBCCs. Intratumoral T2-hyperintense foci (57% vs. 13%; p < 0.05) were more frequently observed in cBCCs than in cSCCs.
CONCLUSION
cBCCs predominantly occurred on the nose with intratumoral T2-hyperintense foci, whereas cSCCs predominantly exhibited a flattened configuration, superficial ulcer formation, protrusion into the subcutaneous tissue, ill-demarcated deep tumor margin, and peritumoral fat stranding.

Keyword

Basal cell carcinoma; Squamous cell carcinoma; Skin cancer; Head and neck; MRI

MeSH Terms

Carcinoma, Basal Cell*
Carcinoma, Squamous Cell*
Epithelial Cells*
Head*
Humans
Magnetic Resonance Imaging*
Neck*
Nose
Skin Neoplasms
Subcutaneous Tissue
Ulcer

Figure

• 

  Fig. 1 87-year-old woman with cutaneous basal cell carcinoma of right nose. A. Axial T2-weighted image (TR/TE, 3000/90 ms) showing well-demarcated, elliptic, cutaneous lesion (arrow) without superficial ulcer formation and protrusion into subcutaneous tissue. B. Axial fat-suppressed T2-weighted image (TR/TE, 3290/80 ms) showing T2-hyperintense foci (arrowheads) within cutaneous lesion (arrow); peritumoral fat stranding is not observed. C. Sagittal fat-suppressed T2-weighted image (TR/TE, 4350/120 ms) clearly showing T2-hyperintense foci (arrowheads) within cutaneous lesion (arrow). D. Histological specimen (H&E stain, × 2.5) showing well-demarcated mass in dermis with multiple cystic cavities filled with mucinous contents. H&E = hematoxylin and eosin, TE = echo time, TR = repetition time

• 

  Fig. 2 77-year-old man with cutaneous squamous cell carcinoma of left cheek. A. Axial T2-weighted image (TR/TE, 4100/90 ms) showing ill-demarcated, flattened, cutaneous lesion (arrow) with superficial ulcer formation (arrowhead) and protrusion into subcutaneous tissue. B. Axial fat-suppressed T2-weighted image (TR/TE, 3636/90 ms) showing peritumoral fat stranding (arrowheads) adjacent to cutaneous lesion (arrow); T2-hyperintense foci are not seen. C. Coronal fat-suppressed T2-weighted image (TR/TE, 4542/90 ms) clearly showing peritumoral fat stranding (arrowheads) adjacent to cutaneous lesion (arrow). D. Histological specimen (H&E stain, × 2.5) shows ill-demarcated mass infiltrating subcutaneous fat tissue.

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