Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jun:150:119-129.
doi: 10.1016/j.ejca.2021.03.026. Epub 2021 Apr 23.

Computed tomography-guided biopsy of radiologically unclear lesions in advanced skin cancer: A retrospective analysis of 47 cases

Cindy Franklin  1 , Axel Wetter  2 , Hideo Andreas Baba  3 , Jens Theysohn  2 , Johannes Haubold  2 , Ioana Cosgarea  4 , Eva Hadaschik  5 , Elisabeth Livingstone  5 , Lisa Zimmer  5 , Ingo Stoffels  5 , Joachim Klode  5 , Georg Lodde  5 , Jan-Malte Placke  5 , Dirk Schadendorf  5 , Selma Ugurel  5
Affiliations
Case Reports

Computed tomography-guided biopsy of radiologically unclear lesions in advanced skin cancer: A retrospective analysis of 47 cases

Cindy Franklin et al. Eur J Cancer. 2021 Jun.

Abstract

Background: Radiological imaging such as computed tomography (CT) is used frequently for disease staging and therapy monitoring in advanced skin cancer patients. Detected lesions of unclear dignity are a common challenge for treating physicians. The aim of this study was to assess the frequency and outcome of CT-guided biopsy (CTGB) of radiologically unclear, suspicious lesions and to depict its usefulness in different clinical settings.

Methods: This retrospective monocentric study included advanced skin cancer patients (melanoma, Merkel cell carcinoma, squamous cell carcinoma, angiosarcoma, cutaneous lymphoma) with radiologically unclear lesions who underwent CTGB between 2010 and 2018.

Results: Of 59 skin cancer patients who received CTGB, 47 received CTGB to clarify radiologically suspicious lesions of unclear dignity. 32 patients had no systemic therapy (cohort A), while 15 patients received systemic treatment at CTGB (cohort B). In both cohorts, CTGB revealed skin cancer metastasis in a large proportion of patients (37.5%, 40.0%, respectively), but benign tissue showing inflammation, fibrosis or infection in an equally large percentage (37.5%, 46.7%, respectively). Additionally, a significant number of other cancer entities was found (25.0%, 13.3%, respectively). In patients receiving BRAF/MEK inhibitors, CTGB confirmed suspicious lesions as skin cancer metastasis in 83.3%, leading to treatment change. In immune checkpoint inhibitor-treated patients, skin cancer metastasis was confirmed in 11.1% of patients only, whereas benign tissue changes (inflammation/fibrosis) were found in 77.8%.

Conclusions: Our results highlight the relevance of clarifying radiologically unclear lesions by CTGB before start or change of an anti-tumour therapy to exclude benign alterations and secondary malignancies.

Keywords: CT-Guided biopsy; Histopathology; Immune checkpoint inhibitor; Melanoma; Skin cancer.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest statement All conflict of interest listed in the manuscript have been outside the submitted work and do not influence the submitted work. Therefore, the authors declare no competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. CF has been on the advisory board of or received honoraria from BMS and Novartis and received travel grants from BMS, Novartis and Pierre Fabre outside the submitted work. EL served as consultant or/and has received honoraria from Amgen, Actelion, Roche, Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Janssen, Medac, Sanofi, Sun Pharma and travel support from Amgen, Merck Sharp & Dohme, Bristol-Myers Squibb, Amgen, Pierre Fabre, Sun Pharma and Novartis outside the submitted work. JT served as a consultant or/and has received honoraria from Roche and Boston Scientific outside the submitted work. EH received honoraria for consulting and travel expenses from Biotest outside the submitted work. LZ: Honoraria from Roche, BMS, MSD, Novartis, Pierre Fabre; Consultant or Advisory Role: BMS, Novartis, Pierre Fabre, Sun Pharma, Sanofi, MSD; Research funding to institution: Novartis; Travel support: BMS, Pierre Fabre, Sanofi, Amgen, Novartis, Sun Pharma. All fundings were outside the submitted work. DS declares advisory board and speakers honoraria from Roche, Novartis, Bristol-Myers-Squibb, MSD, Merck-Serono, Sanofi, Nektar, Amgen, Hexal, InFlaRx, Array, Pierre Fabre, Immunocore, Philogen Sun Pharma, Regeneron and Ultimovacs, as well as grant and travel support from Roche, Novartis, Bristol-Myers-Squibb, MSD, Merck-Serono, and Sanofi outside the submitted work. SU declares research support from Bristol Myers Squibb and Merck Serono; speakers and advisory board honoraria from Bristol Myers Squibb, Merck Sharp & Dohme, Merck Serono, Novartis and Roche, and travel support from Bristol Myers Squibb, and Merck Sharp & Dohme outside the submitted work. AW, HAB, JH, IC, IS, JK, J-MP, GL declare no conflict of interest.

Publication types

Substances