Browsing by Author "Crisan, Maria"

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    Präoperativer Hochfrequenzultraschall: Ein zuverlässiges Managementinstrument bei nichtmelanozytärem Hautkrebs der Ohrmuschel und der Nase
    (2024) Crisan, Diana; Wortsman, Ximena; Catalano, Orlando; Badea, Radu; Kastler, Sabine; Badea, Alexandru; Manea, Avram; Scharffetter-Kochanek, Karin; Strilciuc, Stefan; Crisan, Maria; Schneider, Lars Alexander
    Hintergrund und ZielsetzungDas Wissen & uuml;ber die Tiefeninfiltration bei nichtmelanozyt & auml;rem Hautkrebs (NMSC) mithilfe pr & auml;operativer Sonographie k & ouml;nnte den & Auml;rzten erm & ouml;glichen, den am besten geeigneten therapeutischen Ansatz zu w & auml;hlen, unn & ouml;tige Operationen und teure bildgebende Verfahren zu vermeiden und die Diagnose und Behandlung nicht zu verz & ouml;gern. In unserer retrospektiven, monozentrischen Studie haben wir die N & uuml;tzlichkeit des Hochfrequenzultraschalls (HFUS) zur Beurteilung der Tiefeninfiltration bei aurikul & auml;ren und nasalen NMSC-F & auml;llen untersucht und die darauffolgende & Auml;nderung des therapeutischen Ansatzes bewertet.Patienten und MethodikIn 60 NMSC-F & auml;llen haben wir die Genauigkeit des HFUS bei der Erkennung von Knorpel- und Knocheninfiltration sowie die Korrelation sonographischer und histologischer Parameter beurteilt.ErgebnisseIn 16,6% der F & auml;lle wurde pr & auml;operativ eine tiefe Knorpel-/Knochenbeteiligung oder eine lokoregionale Erkrankung identifiziert, was zu einer ge & auml;nderten therapeutischen Strategie mit radioimmunologischer Behandlung anstelle von Operation f & uuml;hrte. In zwei F & auml;llen identifizierte der pr & auml;operative HFUS eine lokale Knorpelinfiltration, was die Anzahl der chirurgischen Eingriffe reduzierte. Bei den verbleibenden 48 L & auml;sionen ohne Tiefeninfiltration wurde eine Korrelation von > 99% zwischen der histologischen und sonographischen Tumoreindringtiefe gefunden (p <0.001).SchlussfolgerungenPr & auml;operativer HFUS beeinflusst das therapeutische Vorgehen bei NMSC, indem es eine subklinische Beteiligung tieferer Strukturen erkennt, umfangreichere diagnostische Ma ss nahmen vermeidet, Kosten reduziert und die Qualit & auml;t der Gesundheitsversorgung verbessert. HFUS sollte in der Dermatochirurgie vor der Tumorentfernung zur optimierten Therapie und zur verbesserten Patientenberatung eingesetzt werden.
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    Pre-operative high-frequency ultrasound: a reliable management tool in auricular and nasal non-melanoma skin cancer
    (2024) Crisan, Diana; Wortsman, Ximena; Catalano, Orlando; Badea, Radu; Kastler, Sabine; Badea, Alexandru; Manea, Avram; Scharffetter-Kochanek, Karin; Strilciuc, Stefan; Crisan, Maria; Schneider, Lars Alexander
    Background and objectives: The knowledge of depth infiltration in non-melanoma skin cancer (NMSC) using pre-operative ultrasound could enable clinicians to choose the most adequate therapeutic approach, avoiding unnecessary surgeries and expensive imaging methods, delaying diagnosis and treatment. Our single-center retrospective study determined the usefulness of high-frequency ultrasound (HFUS) for depth infiltration assessment in auricular and nasal NMSC and assessed the subsequent change in therapeutic approach.Patients and Methods: In 60 NMSC cases, we assessed the accuracy of HFUS in cartilaginous/bone infiltration detection as well as the correlation of sonographic and histological parameters.Results: In 16.6% of cases, a deep cartilaginous/bone involvement or locoregional disease was identified pre-operatively, resulting in a changed therapeutical scheme of radio-immunological treatment rather than surgery. In two cases, pre-operative HFUS identified local cartilage infiltration, reducing the number of surgical procedures. Forty-eight remaining lesions with no depth infiltration were excised; a correlation of > 99% between the histologic and sonographic tumor depth (p<0.001) was found.Conclusions: Pre-surgical HFUS influences the therapeutic management in NMSC by detecting subclinical involvement of deeper structures, avoiding more extensive diagnostics, reducing costs, and improving healthcare quality. High-frequency ultrasound should be implemented in dermatosurgery before tumor excision for optimized therapy and improved patient counseling.
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    The Usefulness of Ultrasonography for Supporting the Differentiation, Diagnosis, and Treatment of Atypical Fibroxanthoma and Pleomorphic Dermal Sarcoma
    (2024) Crisan, Diana; Schneider, Lars Alexander; Scharffetter-Kochanek, Karin; Bernhard, Lukas; Crisan, Maria; Wortsman, Ximena
    Atypical fibroxanthoma (AFX) and pleomorphic dermal sarcoma (PDS) are rare histomorphological variants of a disease spectrum. After ruling out other tumor entities by immunohistochemistry, PDS can be differentiated from AFX by infiltration into the subcutis, while AFX remains confined to the dermis. The therapeutic approach is more aggressive in PDS as it can potentially metastasize. We assessed the usefulness of preoperative sonography in differentiating between the two tumor entities by identifying a potential subcutaneous infiltration. In our patients (n = 13), preoperative sonography identified and differentiated AFX and PDS with 100% accuracy and even changed the initial histological suspicion of AFX to PDS in 3 cases (23%), which was confirmed after tumor resection. Preoperative sonography of these tumors could strengthen the clinical diagnosis, avoid a delay in therapy initiation and improve patient counseling. While for AFX, micrographic-controlled surgery suffices, for PDS, resection with 2 cm safety margins and lymph node sonography to rule out lymphonodal involvement is necessary. Hence, ultrasonography can improve clinical practice by providing helpful information for dermatosurgeons, which cannot be obtained during clinical examination.