Raman spectroscopy aided evaluation of basal cell carcinoma diagnosis: A case report

Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer, and primarily diagnosed by invasive and time-consuming histopathological biopsy, highlighting the need for rapid, non-invasive adjunctive tools. We report the case of a 93-year-old patient presenting with a suspicious scalp lesion who underwent dermoscopy, Wood's lamp examination, and in vivo Raman spectroscopy prior to biopsy. Conventional clinical examinations suggested a malignant lesion but were unable to determine the specific tumor type, whereas Raman spectra displayed high similarity to former BCC cases and clear separation from actinic keratosis cases by principal component analysis. Characteristic Raman peaks associated with collagen (936 and 1657 cm⁻¹), glycine (1204 cm⁻¹), and phospholipids (1445 cm⁻¹) were identified, consistent with molecular alterations reported in BCC. Although the initial histopathological assessment suggested a benign lesion, subsequent expert review together with immunohistochemical analysis confirmed BCC, aligning with the Raman spectroscopy findings. This case further demonstrates the potential of Raman spectroscopy to complement conventional histopathology and assist in the identification of diagnostically challenging BCC cases.