[Descriptive study on basal cell eyelid carcinoma]

Clinical and pathological diagnosis and comparison of benign and malignant eyelid tumors

PURPOSE

To assess and compare demographic and clinical features of benign and malignant eyelid tumors from 2011 to 2018 in a tertiary medical center.

MATERIALS AND METHODS

The study was conducted retrospectively from medical records to compare demographic and clinical characteristics and recurrence of benign and malignant eyelid tumors after obtaining institutional review board approval. A total of 428 eyelid tumors with histopathologic diagnoses were studied. Premalignant lesions were not included. The lesions were classified into two groups according to malignancy: benign and malignant eyelid lesions.

RESULTS

Among the 428 histopathologically confirmed eyelid lesions, 373 (87.1%) were benign and 55 (12.9%) were malignant. The patients with malignant eyelid tumors had a higher mean age at diagnosis than patients with benign eyelid tumors (P=0.012). The most common benign eyelid tumors were squamous papilloma (17.7%), xanthelasma (11.5%), and epidermal cysts (11.3%). The most common malignant eyelid tumors were basal cell carcinomas (65.5%), squamous cell carcinomas (14.5%), and sebaceous gland carcinomas (7.3%). There was no relative gender predominance between patients with benign and malignant eyelid tumors (P=0.287). Benign eyelid tumors were most commonly located on the right side and upper eyelid (P=0.027 and 0.036, respectively). Malignant tumors had a higher rate of recurrence (P=0.002).

CONCLUSION

Differentiation between benign and malignant eyelid lesions is important, since it may lead to cosmetic complications and serious morbidity, particularly in patients with malignant eyelid tumors.

Periocular Basal Cell Carcinoma: 20-Years Experience at a Tertiary Eye Care Center of South India

PURPOSE

To study the clinical profile and management outcomes of periocular basal cell carcinoma (BCC).

MATERIALS AND METHODS

A retrospective analysis of all histopathologically proven cases of BCC between 1995 and 2015 was done. The demographic data, clinical presentation, histopathological subtype, and management outcomes were analyzed.

RESULTS

We had a total of 185 malignant eyelid tumors during the study period, out of which 37 (20%) were BCC. Thirty-two (86.5%) out of 37 cases were primary BCC. The mean age was 63.3 years. Pigmented ulcerative lesion (14, 38%), lower eyelid (19, 51%), and nodular BCC (15, 40%) were the most common presentation, periocular site, and histological subtype, respectively. 28 patients underwent excision under frozen section with an average tumor-free margin of 3.5 mm. Mean follow-up period was 18.78 months. Recurrence rate of 0% and 3.1% was noted in primary and recurrent BCC, respectively.

CONCLUSION

Periocular BCC commonly presents as pigmented ulcerative lesion in the lower lid. Excision biopsy under frozen section with an average tumor-free margin of 3.5 mm offers cure in most cases.

Clinical Characteristics and Outcome of Malignant Eyelid Tumors: A Five-Year Retrospective Study

Introduction

To the best of our knowledge, this is the first study about malignant eyelid tumors in the region of Tuzla, Bosnia and Herzegovina, and it shows similar results comparing with other countries (the annual incidence of eyelid tumors in Tuzla region is about 3.73/100 000 population). Malignant eyelid tumors are relatively uncommon, but potentially fatal disease. However, if detected early and treated adequately, the prognosis is generally excellent.

Aim

The aim of this study was the clinical and microscopical analysis of malignant eyelid tumors in treated patients, the presentation of surgical treatment and reconstructive methods of eyelid tumors.

Methods

This retrospective study included 60 patients surgically treated at the University Clinical Center Tuzla from January 2012 to December 2016, who were initially diagnosed with malignant eyelid tumors in accordance to the final results obtained by histological examination of excised lesions.

Results

In the group of malignant tumors, the most common tumors were BCC (85%), which were predominantly found on the lower eyelids (92.16%) and showed female predominance (51.06%). SCC was the second most common eyelid malignancy (15%) and showed a predilection for the lower eyelid involvement and male predominance (55.56%). Tumors up to 2 cm in diameter (clinical stage T1) were found in 78.33% of cases, 95.74% of which with radical excision, while 4.26% with non-radical excision.

Conclusion

Treatment by complete excision with histological confirmation of tumor clearance is recommended. Perineural spread is an adverse prognostic sign, which may require postoperative radiotherapy. Orbital invasion is a rare complication but, if recognized early, it can be treated effectively with exenteration. Because presentation varies and histological examination is required for accurate diagnosis, any suspicious lesion occurring on the eyelids should be excised or biopsied. All patients with malignant tumors should be advised of the risk of recurrent or new tumors and encouraged to attend lifelong follow up.

Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment

Basal cell carcinoma (BCC) is a common malignant tumor throughout the world. One of the known risk factors of BCC is intense exposure to ultraviolet radiation. More than 50% of BCCs of the eyelid initially occur on the lower lid. The gold standard of diagnosis of BCC is histopathology. Treatment options for BCC consist of surgery, vismodegib, radiotherapy and imiquimod. Surgical excision using Mohs micrographic surgery or wide surgical excision with frozen section margin control is the first consideration for treatment of periocular BCC. Eyelid reconstruction should be carefully considered as both function and esthetic outcome in patients are important after clear excision of tumors. Exenteration is considered in the case of extensive orbital invasion or high-risk aggressive tumors in order to reduce the rate of recurrence.