RECURRENT PERIOCULAR BASAL CELL CARCINOMA. CASE REPORT.

Abstract

We present the management of asevere case of recurrent periocular basal cell carcinoma, orbital invasion and exenteration. The present case is of arecurrent basal cell carcinoma in a84-year-old male presenting with non-healing lesion above right eyelid. Atumor excision was performed in May 2014. Histopathology revealed abasal cell carcinoma (dg. C44.1 ICD-10-CM) with positive margins. The re-excision of the lesion was performed. After two years, there was alocal recurrence and orbital invasion. Indication for external curative radiation therapy. Plastic surgery of the upper eyelid. Orbital exenteration was indicated in January 2018. After another year, arecurrence of the tumor was once again noted. Histopathology revealed abasal cell carcinoma (dg. C44.1 (TNM 7, pMx, pNx, pTx)). The patient was indicated for external radiotherapy. There were no indications for biological treatment. After another year, aprogression of the local finding was noted. Basal cell carcinoma (BCC) is the most common non-melanoma skin cancer of the periocular region. Primary treatment of basal cell carcinoma is surgical. Advanced lesions require extensive surgical interventions and other available treatment modalities. In some cases, mutilating surgery - exenteration of the orbit is inevitable. Despite arelatively small percentage of invasive diseases today, advanced stages may still occur; either as aresult of the patient'slate presentation, inadequate initial therapy aimed at maintaining critical periorbital structures, or due to high tumor aggression. The case report highlights necessity of radical resection of primary tumor with histological examination.