Radiosurgical removal of a skin lesion - basal cell carcinoma (basal cell epithelioma)

Basal cell carcinoma (also known as basalioma) is the most common form of skin cancer, with slow evolution, local invasive potential, but an extremely low risk of metastasis. It occurs mainly in older individuals, in areas chronically exposed to UV radiation: the face, neck, scalp, ears, and upper chest.

Radiofrequency cauterization of cutaneous lesions is a minimally invasive dermatological procedure that uses radiofrequency waves for the controlled removal of superficial lesions. In the case of basal cell carcinoma, this method is indicated for superficial, well-defined forms, clinically and dermoscopically confirmed, under the strict supervision of a dermatologist.

Basal cell carcinoma develops from the basal cells of the epidermis and may present in various forms: a translucent (pearly) nodule, an ulcer with indurated borders, an erythematous-scaly plaque, or a pigmented lesion. Although it is a malignant tumor, the prognosis is excellent when it is treated early and correctly.

Radiofrequency cauterization may be an effective therapeutic option for:

• early-stage or recurrent forms;
• superficial lesions without deep invasion;
• patients with contraindications to conventional surgical excision.

Components Evaluated Before the Procedure

• Confirmation of the diagnosis through dermoscopic and/or histopathological examination
• Clinical form: superficial, nodular, or pigmented
• Size and depth of the lesion
• Anatomical location (with caution in functionally and aesthetically sensitive areas)
• Assessment of recurrence risk (immunosuppression, advanced age, previous recurrences)

Purpose of the Procedure

• Complete removal of the tumor in early stages
• Prevention of deep tissue invasion
• Ensuring a satisfactory aesthetic result
• Collection of tissue for histopathological analysis (if not previously performed)

Indications

• Superficial or small nodular basal cell carcinoma confirmed by dermoscopy
• Lesions located in areas with low functional and aesthetic risk
• Patients with contraindications to conventional surgery
• Recurrences previously treated by other methods (after evaluation)

Contraindications

• Suspicion of melanoma or another aggressive form of skin cancer
• Large or deeply infiltrative lesions (requiring complete surgical excision)
• Active infection in the treatment area
• Severe coagulation disorders or decompensated systemic conditions

Procedure

• Disinfection of the area and administration of local anesthesia
• The lesion is excised or vaporized using a radiofrequency electrode
• A sterile dressing is applied
• Post-procedure instructions are provided

Procedure duration: 15–30 minutes
Complete healing: 10–14 days

Advantages of the Method

• Fast, safe, and effective intervention
• Superior aesthetic result compared with classical methods
• Short recovery time, without the need for hospitalization
• Several lesions can be treated during the same session
• Minimal trauma to adjacent tissues

Post-Procedure Recommendations

• Keep the treated area clean and dry
• Avoid sun exposure until complete healing
• Do not remove formed crusts — they will fall off naturally
• Follow the physician’s recommendations regarding hygiene and antiseptic application
• Dermatological follow-up consultation after 4–6 weeks
• Annual screening for patients with increased oncological risk
   

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC2840884/ https://www.cancertherapyadvisor.com/factsheets/basal-cell-carcinoma-stages/
https://emedicine.medscape.com/article/276624-treatment?form=fpf
https://www.sfpathol.org/media/pdf/update-of-the-european-guidelines-for-basal-cell-carcinoma-management-eur-j-dermatol-2014.pdf
https://www.aafp.org/pubs/afp/issues/2015/1001/p601.htm