The role of reflectance confocal microscopy as an aid in the diagnosis of collision tumors

Elvira Moscarella, Harold Rabinovitz, Margaret C. Oliviero, Lise Brown, Caterina Longo, Iris Zalaudek, Simonetta Piana, Francesca Farnetani, Aimilios Lallas, Giuseppe Argenziano, Giovanni Pellacani

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


Background: The term 'collision tumor' refers to the association of 2 or more different neoplasms within the same lesion. The association of a benign neoplasm with a malignant neoplasm is of particular significance and warrants diagnostic accuracy. Objective: The purpose of our study was to see if reflectance confocal microscopy (RCM) was a valuable tool when dealing with collision tumors. Methods: We retrospectively evaluated 24 histologically confirmed cases of collision tumors, which were initially assessed using dermoscopy and RCM. Results: The malignancy most commonly detected in association with collision tumors was basal cell carcinoma (BCC) (n = 13), followed by melanoma (n = 5, of which 2 collided with BCC) and squamous cell carcinoma in situ (n = 4). Seborrheic keratoses were the most common benign neoplasms found in association with collision tumors (n = 18), followed by nevi (n = 7). Dermoscopy revealed the malignant component in 14 out of 20 lesions compared to RCM, which revealed a malignant component in 19 out of 20 neoplasms. There was excellent concordance between RCM and histopathology with regard to the identification of a malignant component within a tumor (kappa value >0.9). Conclusion: The dermatoscope and the reflectance confocal microscope, when used in conjunction, are valuable tools aiding in the diagnosis of collision tumors.

Original languageEnglish (US)
Pages (from-to)109-117
Number of pages9
Issue number2
StatePublished - Nov 2013
Externally publishedYes


  • Basal cell carcinoma
  • Collision tumors
  • Dermoscopy
  • Melanoma
  • Reflectance confocal microscopy
  • Seborrheic keratoses
  • Squamous cell carcinoma

ASJC Scopus subject areas

  • Dermatology


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