High-Frequency Ultrasound Assessment of Basal Cell Carcinoma: Correlations Between Histopathological Subtype, Vascularity, and Age/Sex Distribution

<b>Background</b><b>:</b> High-frequency ultrasound (HFUS) has emerged as a valuable non-invasive imaging modality for the preoperative assessment of basal cell carcinoma (BCC). However, its ability to reliably differentiate between histopathological subtypes based on morphological and vascular characteristics requires further validation. <b>Methods:</b> Between January 2010 and December 2011, 320 patients with a total of 330 histologically confirmed BCC lesions were examined using HFUS (15-18 MHz linear transducer). Lesions were classified according to ultrasound contour (sharp vs. irregular) and vascularity (hypervascular vs. hypovascular) and correlated with histopathological subtype (solid vs. infiltrative). Postoperative ultrasound follow-up was performed in a subset of patients for recurrence detection. <b>Results:</b> Solid BCCs were predominantly characterised by sharp, well-defined margins, whereas infiltrative tumours more frequently exhibited irregular contours. This association was highly significant (χ² = 24.7, df = 1, <i>p</i> < 0.001; OR = 71.9, 95% CI: 37.0-139.8). Vascularity patterns also differed significantly between subtypes: solid tumours were more likely to present with hypervascular features, while infiltrative tumours more frequently exhibited hypovascular patterns (χ² = 23.8, df = 1, <i>p</i> < 0.001; OR = 3.24). No statistically significant associations were observed between ultrasound morphology and patient sex or age. Among patients who participated in postoperative HFUS follow-up, seven histologically confirmed recurrences were detected. <b>Conclusions:</b> HFUS provides reliable preoperative information on BCC morphology and vascularity, enabling accurate differentiation between solid and infiltrative subtypes. These findings support the role of HFUS as a valuable adjunct to dermatoscopy in treatment planning and postoperative surveillance of BCC.