Line‐field confocal optical coherence tomography of basosquamous carcinoma: a case series with histopathological correlation.

Background: Basosquamous carcinoma (BSC) is a rare and potentially aggressive cutaneous neoplasm combining histopathological features of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Line‐field confocal optical coherence tomography (LC‐OCT) is a new, non‐invasive imaging technique featuring excellent resolution and penetration. To date, studies about the use of LC‐OCT in the BCC and SCC fields are available, but similar investigations are lacking in the BSC field. Objective: The goal of the present study was to identify/describe LC‐OCT criteria of BSC. Methods: Consecutively enrolled BSCs were imaged with dermoscopy and LC‐OCT prior to surgical excision. Dermoscopic and LC‐OCT images were evaluated, and histopathological slides were reviewed. Results: Six BSCs from six patients [four (66.7%) males and two (33.3%) females; mean age 76.5 (62–96) years] were included. Identified LC‐OCT criteria for BSC included BCC‐associated (dermal lobules with millefeuille pattern, dilated vessels, bright cells within the epidermis, bright cells within lobules, stromal stretching, stromal brightness) and SCC‐associated features (acanthosis, hyperkeratosis, disarranged epidermal architecture, broad strands, elastosis and glomerular vessels). Interruption of the dermal–epidermal junction and ulceration represented overlapping criteria. Conclusion: Line‐field confocal‐OCT is a new promising technique that may support the non‐invasive recognition of BSC through the simultaneous detection of BCC‐associated and SCC‐associated features. We hypothesize that the use of LC‐OCT might be helpful not only in the diagnostic setting but also in the follow‐up surveillance for an early identification of recurrences. Further larger studies are needed to prove this hypothesis. [ABSTRACT FROM AUTHOR]