Basal Cell Carcinoma Of Eyelid Research Articles

Outcomes after photodynamic therapy of basalcell carcinoma on the eyelid skin with intravenous administration of photosensitizer chloride E6

Purpose. To evaluate immediate and long-term outcomes after photodynamic therapy (PDT) of basal cell carcinoma (BCC) on the eyelid with intravenous administration of photosensitizer (PS) chlorine E6.Materials and methods. PDT was performed in 261 patients with a verified diagnosis of BCC of the eyelid cT1-3N0MO, stage I–II, aged 38 to 87 (average 68.7 ± 15.6). PS chlorin E6 (Photolon, Photoditazin, Radachlorin) was used intravenously at dosage 1.0–1.5mg/kg; 1–2 courses. Light dosage ranged from 100 to 300 J/cm2, depending on the neoplasm clinical form and the data of fluorescence diagnostics.Results. Complete regression after the first PDT course of eyelid BCC cT1-3N0M0 with intravenous administration of PS chlorin E6 was obtained in 90.4 % of cases; after 2 courses - in 96.2 % of cases. During the follow-up period from 5 to 15 years, relapses were diagnosed in 7.6 % of cases. The number of relapses depended on the process stage. In neoplasms corresponding to the symbol cT1a, the number of relapses was 1.4 %, cT1 b – 5.0 %, cT1 c– 8.3 %, cT2 a – 2.5 %, cT2 b – 5.0 %, cT2 c – 9 %, cT3 a – 5.8 %, cT3 b – 43.8 %, cT3 c – 46.7 %. Good and excellent cosmetic results were seen too.Conclusion. PDT of eyelid BCC of stage I–II with intravenous administration of PS chlorine E6 is an effective and low-risk method for anatomical and functional disorders. It can be an alternativetechnique to surgical treatment. The discussed way of treatment should be personalized and provided in specialized medical settings.

Challenges in Diagnosing and Initial Treatment of Advanced Eyelid Basal Cell Carcinoma in Rural Area: A Case Report

Introduction : Basal cell carcinoma (BCC) is the most common non-melanoma eyelid cancer with a high risk of recurrence. This case report discusses the management of extensive BCC in a rural setting with limited resources.
 Case Illustration : A 62-year-old Timorese female, presented to the hospital with a mass on the left periocular region. It appeared as a mole in the lower left eyelid and extended to the surrounding tissues over nine years. As a farmer, she was frequently sun-exposed. A blackish mass was found at the left orbit, buccal, and entire nose (8 x 7.5 cm) with an ulcerated surface and attached firmly. The right eye had bedside visual acuity >6/60, with palpebral edema, free eye movement, hyperemia nasal conjunctiva, and transparent cornea. The left eye is difficult to examine. Two submandibular lymphadenopathies were palpated. A Head CT scan showed a suspected malignant soft tissue mass with irregular thickening of soft tissue with ill-defined borders. Histopathology examination revealed a nodulocystic type of basal cell carcinoma.
 Discussion : Locally advanced BCC cases need a multidisciplinary approach. In a limited resources setting, the treatment highlights are histological diagnosis, complete surgical excision, and exenteration with margin control. From a broader perspective, the role of primary health care in educating and revering for early treatment is paramount.
 Conclusion : Prevention and early treatment are the most important factors in managing locally advanced BCC.

Recurrence rates of periocular basal cell carcinoma following intra-operative en-face frozen section margin controlled excision.

To report the margin control process and rate of recurrence of periocular basal cell carcinomas (BCCs) managed by en-face, frozen section margin controlled (FSC), excision by a single surgeon with a 3-year follow-up. A retrospective analysis of all histopathologically proven cases of periocular BCC who underwent surgical excision with intra-operative, en-face, FSC, excision by a single surgeon from 2015 to 2019 was performed. Patients with less than 3-year follow-up were offered a virtual appointment to determine possible recurrence. A total of 88 BCC excisions from 86 patients were reviewed. Minimum 3-year follow-up data is available for 73 patients. The most common location and histological subtype was the lower eyelid and nodular BCC, respectively (47% and 83% of cases). Primary BCC (pBCC) comprised 98% (86/88) of cases and recurrent BCC (rBCC) comprised 2% (2/88) of cases. Negative frozen section margins were achieved in 93% (82/88) of excisions on the day of surgery. The overall recurrence rate during this time was 1.4% (1/73) at minimum 3years. Periocular BCC can be managed effectively by en-face, FSC, excision, with a high cure rate and low recurrence rate comparable to alternative excision techniques such as Moh's micrographic surgery. Advantages of en-face excision include same-day excision and reconstruction and reduced theatre time. Primary nodular BCCs with clear margins can be considered for early discharge with advice to self-monitor.

Incidence of malignant eyelid tumors: A 6-year period review (2015–2021)

Abstract Background: Basal cell carcinoma (BCC), the most common malignant tumor, accounts for 85%–95% of cases of eyelid malignant tumors. Demographic factors such as age, gender, tumor location, and subtype play a crucial role in epidemiological knowledge. We investigated eyelid BCC diagnosis and treatment at the Department of Ophthalmology in Centro Hospitalar de Setúbal (CHS). Methods: A retrospective study was conducted on patient cases with suspected eyelid epithelial tumors who underwent excisional biopsy surgery. The study included data from the CHS database between 2015 and 2021. Data collection and subsequent analysis were based on histopathological results. Results: In our study, were analyzed a total of 47 tumor cases, with 68.1% located on the lower eyelids and 31.9% on the upper eyelids. Among these cases, 25 (53.2%) were classified as benign, while 22 (46.8%) were identified as malignant eyelid tumors. BCCs accounted for 90.9% of all malignant cases, with an average age of 71.7 ± 16.6 years. The nodular subtype was the most prevalent, followed by infiltrative and superficial subtypes. Superficial BCC patients were older than infiltrative BCC patients (median age = 69.5 years vs. 61.5 years). BCC primarily affected the lower eyelids compared to the upper eyelid, and there was a slight female predominance (n = 11). All diagnosed BCCs correlated with sun-exposed regions. Conclusions: Timely intervention is crucial for reducing morbidity. These findings emphasize the need for improved registration and notification systems to enhance the prevention and treatment of eyelid BCCs. Furthermore, despite advancements in ultraviolet-blocking technologies, further development of sunscreen specifically formulated for ocular use remains necessary to reduce the incidence of eyelid tumors.

Post-operative interventional radiotherapy (brachytherapy) in advanced ocular surface and eyelid tumors as an alternative to surgical retreatment.

The main purpose of treatment of advanced ocular surface and periocular malignant tumors is to eradicate the tumor while trying to preserve visual function and aesthetics. Our purpose is to describe the outcome of a retrospective case series of 10 patients with advanced ocular surface and periocular tumors treated surgically in first instance and then with postoperative interventional radiotherapy (IRT/Brachiterapy). We describe the clinicopathological features, treatments and outcome, in a retrospective case series of 10 patients with advanced tumors involving ocular surface (staging ≥ T2) and eyelids (staging ≥ T3), with involvement of periocular and/or orbit tissues. Patients were first surgically treated, most of them with incomplete excision, and then underwent a post-operative interventional radiotherapy (IRT/Brachytherapy) as an alternative to more invasive and disfiguring surgical retreatment. Tumor location, risk factors, staging, histological features, and follow-up timing were analyzed. Three patients had advanced eyelid basal cell carcinomas, 2 patients were diagnosed with eyelid and conjunctival squamous cell carcinomas, 3 as sebaceous carcinomas, and 2 as primary conjunctival melanomas. The mean follow-up time from IRT to last clinical follow-up was 58.6 weeks, range 28.4-168 (median 43.65, IQR 28.9-72.9). Two patients - one with ocular surface SCC, the other with conjunctival melanoma - had a local recurrence 23.4 and 40,9 weeks after IRT, respectively. An overview of the current knowledge on adjuvant or post-operative IRT is also provided. IRT can be considered an effective therapeutic option to avoid more invasive surgical retreatment in advanced tumors involving eyelids and ocular surface.

Are we Capable of Contributing to the Reduction of Eyelid Basal Cell Carcinoma? Building a Healthcare Team

Background: Basal cell carcinoma (BCC) is the most common malignant eyelid tumour encountered by oculoplastic surgeons (ophthalmologists), contributing significantly to morbidity. The objective of this study was to assess awareness levels and knowledge among healthcare professionals and the general public, regarding eyelid BCC, with a specific focus on the following areas: risk factors, prevention habits and pharmaceutical counseling. Methods: A cross-sectional survey study was employed for data collection. Anonymous surveys were distributed to two distinct groups: healthcare professionals (comprising physicians, pharmacists, and pharmacy students) and members of the general community in Setúbal. Data collection took place on a single day for each of these two groups. Results: The study encompassed 201 participants, consisting of 155 (77.1%) females (mean age = 42 years-old), and 44 (21.9%) males (mean age = 46 years-old). The survey revealed that 55.2% of respondents were unaware of the typical location of eyelid BCC. Furthermore, the majority of participants expressed consensus on the importance of applying sunscreen as a preventive measure. Conclusion: The study underscores the necessity for enhanced efforts in preventing eyelid BCC, emphasizing the crucial role of implementing protocols and educational initiatives targeting both healthcare professionals and the general public. These measures are essential to raise awareness, facilitate early detection, and enhance the management of eyelid BCC cases.

Predictive Value of the International Classification of Diseases, 9th Revision Codes for Identifying Ocular Oncology Diagnoses

Introduction: The aim of this study was to determine the predictive value of International Classification of Diseases, 9th Revision (ICD-9) billing codes for identifying ocular oncology diagnoses. Methods: Population-based retrospective cohort study of all Olmsted County, Minnesota residents with any ocular neoplasm-related ICD-9 code from January 1, 2006 to October 1, 2015. All medical records were reviewed for confirmation of ocular neoplasm. Diagnoses with ≥5 cases confirmed via a medical record review were compared to corresponding ICD-9 codes. Main outcome measures included positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity of ICD-9 codes. Results: Among 3,932 subjects with ≥1 ocular neoplasm-related ICD-9 code, 21 diagnoses met study criteria. The most frequent intraocular, extraocular/orbital, and ocular surface diagnoses were choroidal nevus (n = 824), epidermal inclusion cyst (n = 263), and conjunctival nevus (n = 74), respectively. PPVs ranged from 1.2% to 73.8%, NPVs from 96.9% to 100%, sensitivity from 0% to 100%, and specificity from 85.7% to 100%. Among malignant neoplasms, PPV ranged from 0% to 73.8%: ocular surface squamous neoplasia (PPV: 0%), choroidal melanoma (PPV: 25.0%), eyelid squamous cell carcinoma (PPV: 46.7%), and eyelid basal cell carcinoma (PPV: 73.8%). Among benign neoplasms, PPV ranged from 1.2% (dermoid cyst) to 61.6% (choroidal nevus). Conclusion: There was a wide variation in a predictive value of ocular neoplasm-related ICD-9 billing codes, which suggests that ocular oncology-related claims data alone may overestimate the true number of ocular oncology diagnoses.

Case Report of Lower Eyelid Basal Cell Carcinoma

Basal cell carcinoma is the most common skin cancer in humans and is frequently found in the periocular region. It is the mostcommon type of eyelid cancer, generally characterized by slow growth with rare metastasis and has an excellent prognosis withcurrent surgical techniques. This is a case report of left lower eyelid basal cell carcinoma for which surgical excision with eyelid reconstruction was performed. Histopathological examination of resected mass was consistent with nodulo-ulcerative basal cell carcinoma.Early diagnosis and management of suspicious lesions is important to ensure the clinical result.

A registration trend in eyelid skin cancers and associated risk factors in Iran, 2005–2016

BackgroundEyelid skin cancers are the most prevalent ophthalmic malignancies. This study aimed to evaluate the association of the Human Development Index (HDI) and lifestyle risk factors with eyelid skin cancers in Iran.MethodsThis ecological study analyzed the data collected from the Iranian National Population-based Cancer Registry (2005–2016). The data on provincial-level eyelid skin cancer risk factors were obtained from national sources. The association between provincial HDI and lifestyle risk factors with the prevalence of eyelid skin cancers was assessed.ResultsThe mean 12-year age-standardized incidence rate (ASIR) of eyelid skin cancers was 16.22 per 100,000 (9,104 cases). The overall ASIR showed an upward trend with an estimated annual average increase of 0.006 per year. There were positive correlations between the prevalence of overall eyelid skin cancers and provincial HDI, smoking, and obesity (r = 0.32, 0.42, and 0.37, respectively). In multivariate analysis, obesity/overweight remained a positive predictor for high prevalence of total eyelid skin cancers (OR = 1.97, 95%CI = 1.08–3.58, P = 0.026), carcinoma (2.10, 1.15–3.83, P = 0.015), and basal cell carcinoma (1.48, 0.99–2.20, P = 0.054).ConclusionsAn increasing trend in ASIR of eyelid skin cancers was observed in more than a decade in Iran which was positively associated with provincial HDI and prevalence of obesity. The findings of the study highlight the importance of promotional programs for preventing obesity/overweight and appropriate allocation of screening facilities based on the HDI level.

Correlation between Clinical and Pathological Diagnosis of Eyelid Basal Cell Carcinoma

BCC occurrence is high in the Upper Galilee. Early detection and biopsy sampling can improve cure percentage. Promotion of skin cancer awareness, especially regarding BCC, is mandated in the Upper Galilee population

Recurrence of Basal Cell Carcinoma Treated with Surgical Excision and Histopathological Analysis with Frozen Section Technique with Complete Margin Control (CMC-FS): A 15-Year Experience of a Reference Center.

Basal cell carcinoma (BCC) is the most common type of eyelid malignancy and it is considered to be dangerous due to its proximity to functionally essential organs. Early diagnosis and complete excision of the primary lesion are crucial to prevent infiltration and metastasis. The study aims to evaluate the extent of recurrence in subjects affected by BCC of the upper third of the face treated with surgical eradication and the frozen section technique with complete margin control (CMC-FS), in comparison with the gold standard Mohs micrographic surgery (MMS). The study included 111 patients with 111 biopsy-proven eyelid BCCs. On clinical examination, all lesions were removed with 2 mm margins clinically free of neoplasm. Prior to reconstruction, CMC-FS analysis of all surgical margins was performed on each tumor for histopathologic confirmation. Subsequently, all margins were presented for the permanent paraffin sections. There were 69 primary carcinomas and 42 secondary carcinomas among the 111 samples. No recurrence occurred in 109 tumors followed-up for at least 5 years, with a total recurrence rate of 1.8%. The median time between lesion excision and diagnosis of recurrence was 20 months. at 5-year follow-up, CMC-FS guided excision of BCCs of the eyelids resulted in recurrence rates equivalent to MMS. Intraoperative microscopic control of all margins reduced the recurrence rate of the upper third of the facial BCCs, correlating with easier reconstruction with better esthetic and functional outcome.

Этапная реконструктивно-пластическая хирургия при дефекте нижнего века после удаления базалиомы

Purpose. Evaluation of the effectiveness of multi-staged plastic and reconstructive rehabilitation of the patient with a large lower eyelid defect after the excision of basal cell carcinoma. Material and methods. The patient L., 75 years old, was treated with postoperative coloboma of the lower eyelid, lagophthalmos of the right eye after removal of the eyelid basal cell carcinoma, applied to the S.N. Fyodorov Eye Microsurgery Federal State Institution in Moscow. She underwent a multi-stage reconstructive plastic treatment in order to restore the anatomy and function of the lower eyelid, eliminate the cosmetic defect. Results and discussion. As a result of the first surgical stage, we were able to restore the skin defect using a free skin flap from the upper eyelid of the left eye. The second stage of treatment allowed us to restore the function of the lower eyelid by eliminating the artificial ankyloblepharone created earlier. The consequence of performing the following stages of surgery was the filling of the lack of the mucous membrane of the lower eyelid, the creation of the correct ratio and position of the cutaneous and conjunctival layers of the eyelid, the elimination of lagophthalmos and the restoration of anatomical and functional characteristics of the eyelid. Conclusion. As a result of multi-stage surgical treatment, the anatomical and functional integrity of the lower eyelid was achieved, prevented the loss of visual functions, achieved a satisfactory cosmetic effect, and also improved the patient's quality of life. Keywords: basal cell carcinoma, lower eyelid, staged plastic and reconstructive surgery

The incidence of periocular melanoma: An epidemiologic study in Olmsted County, Minnesota

To the Editor: Melanoma arising in the periocular area presents a unique treatment challenge due to anatomic and functional constraints. To date, most information regarding periocular melanoma is gleaned from extrapolated data from other sites of the body, assuming similar biologic behavior. We aimed to identify the overall incidence, pathologic features, and surgical outcomes of periocular melanoma. Following Institutional Review Board (IRB) approval, using the Rochester Epidemiology Project (a multicenter medical records–linkage system encompassing the Olmsted County population), we identified patients with a first lifetime diagnosis of periocular melanoma between January 1, 1970, and December 31, 2020, while a local resident of Olmsted County, Minnesota. Outside (nonresident) referral cases were excluded. Periocular melanoma was defined as a melanoma arising within the orbital rim – on the upper or lower eyelid, lateral canthus, or eyebrow. A total of 10 patients with primary periocular melanoma were identified. The overall incidence rate of periocular melanoma was 0.2686 per 100,000 patient-years. Among all melanomas diagnosed during that timeframe in Olmsted County, 0.43% were periocular in location. No cases extended onto conjunctiva. The histogenic subtype was lentigo maligna in 8 (80.0%). There was 1 superficial spreading melanoma and 1 case without documentation of histogenic subtype. Incidence of in situ (50.0%) and invasive (50.0%) melanomas was equal. Among invasive melanomas, the average Breslow depth was 0.90 mm (range, 0.2-2.6 mm). Seven (70.0%) were treated with Mohs micrographic surgery (MMS). One (10%) was treated with wide local excision. The 2 cases that did not undergo further surgical treatment were both diagnosed prior to 2000 and were removed entirely via initial excisional biopsy. There was 1 regional metastasis to the parotid gland and lymph node, 2.5 years after diagnosis of a superficial spreading melanoma, Breslow 0.7 mm, status-post treatment with MMS. There were no other local or distant recurrences. There were no melanoma-specific deaths. Mean follow-up time was 7.4 years (range 3.1-13.2). This study demonstrates the relative rarity of periocular melanoma, comprising only 0.43% of all melanomas. Comparatively, basal cell carcinoma (BCC) occurs on the eyelid 16% of the time.1Salomon J. Bieniek A. Baran E. Szepietowski J.C. Basal cell carcinoma on the eyelids: own experience.Dermatol Surg. 2004; 30: 257-263PubMed Google Scholar Our study found an overall periocular melanoma incidence rate of 0.2686 per 100,000 patient-years. A previous Olmsted County cohort reported an incidence of eyelid BCC as 14.35 per 10,000 individuals per year, and an incidence of eyelid SCC as 1.37 cases per 100,000 individuals per year.2Cook Jr., B.E. Bartley G.B. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota.Ophthalmology. 1999; 106: 746-750Abstract Full Text Full Text PDF PubMed Google Scholar The behavior of melanoma seems to parallel primary cutaneous melanoma of head and neck sites. Most tumors were associated with chronic sun exposure; 80% of cases were lentigo maligna subtype. There was 1 regional recurrence in our study, no distant recurrences, and no deaths due to melanoma. The most significant advantage of our study is in its epidemiologic design. The limitations of this study include the retrospective nature of our analysis and the homogenous demographics of Olmsted County, comprised of mostly Caucasian individuals of higher socioeconomic status.3St Sauver J.L. Grossardt B.R. Leibson C.L. Yawn B.P. Melton 3rd, L.J. Rocca W.A. Generalizability of epidemiological findings and public health decisions: an illustration from the Rochester Epidemiology Project.Mayo Clin Proc. 2012; 87: 151-160Abstract Full Text Full Text PDF PubMed Scopus (487) Google Scholar Additionally, some melanomas may have been missed if the tumor was initially labeled as another anatomic site (cheek, nose, temple, etc.) and had extension onto the lid proper. None disclosed. We would like to acknowledge Austin Todd, MS, for his assistance in statistical analysis.

Statistical evaluation and positive predictive value of key features of periorbital basal cell carcinoma

ObjectifDéterminer à quel point certaines caractéristiques suspectes — télangiectasie, madarose et ulcération — présentes dans des lésions périorbitaires permettent d'identifier le carcinome basocellulaire (CBC) avec exactitude et, de ce fait, déterminer si la confirmation histopathologique est toujours nécessaire. MéthodesCette étude rétrospective de patients qui ont subi une biopsie en raison de lésions de la paupière a été réalisée sur une période de 5 ans (2015-2020) dans un établissement unique. Plus précisément, on a noté le diagnostic histopathologique de même que la présence ou l'absence de signes cliniques de madarose, d'ulcération et de télangiectasie. On a ensuite calculé la valeur prédictive positive (VPP) d'un CBC de la paupière de même que le rapport de cotes de chacun de ces signes cliniques. RésultatsAinsi, 179 patients ont subi une biopsie incisionnelle de lésions des paupières. Sur les 79 patients qui présentaient un CBC de la paupière, 96 % avaient une ulcération, 95 %, une madarose et 75 %, une télangiectasie par-dessus la lésion palpébrale, contrairement à 3 %, à 4 % et à 6 %, respectivement, des 100 patients dont les lésions de la paupière étaient bénignes. Voici la VPP d'un CBC de la paupière en présence des 3 caractéristiques suspectes observées: 95,0 % en présence d'ulcération, 96,2 % en présence de madarose et 90,8 % en présence de télangiectasie. La présence de 2 ou des 3 signes chez un même sujet avait une très grande VPP de CBC (VPP = 100 %). ConclusionLa présence d'au moins 2 caractéristiques suspectes permet de conclure presque automatiquement à un diagnostic de CBC. C'est donc dire qu'il n'est peut-être pas nécessaire de réaliser systématiquement une biopsie d'une lésion palpébrale qui présente plusieurs caractéristiques suspectes avant son excision chirurgicale complète. Cependant, en l'absence de multiples caractéristiques explicites d'un carcinome, la lésion doit être soumise à un examen histopathologique.

The Role of Surgery After Remission of Nonsystemic Extensive Periorbital Basal Cell Carcinoma Treated by Vismodegib: A Systematic Review.

Eyelid basal cell carcinoma (BCC) is usually cured by surgery. However, for a minority of patients, extensive disease progression and recurrence contraindicate surgery or radiotherapy because of severe ocular morbidity. The hedgehog signaling pathway inhibitor vismodegib is becoming the key treatment for this specific form. The aim of this review was to define the role of surgery after vismodegib treatment. A literature search of the PubMed, Cochrane Library, ScienceDirect, and Embase databases was conducted for all articles published up to March 2021 to identify studies that examined treatment of BCC of the eyelid by vismodegib. Level 1 evidence was found for the use of vismodegib as neoadjuvant therapy in locally advanced eyelid BCC contraindicated to surgery and/or radiotherapy with a rather good tolerance of treatment. Level 3 evidence was found for the role of surgical excision of residual clinically suspicious lesions as for the indication of eyelid reconstruction after mapping or during residual tumoral resection if frozen sections or Mohs surgery were performed. Vismodegib is a well-tolerated treatment for advanced periorbital BCC. The hedgehog signaling pathway inhibitor vismodegib is a potential treatment option in patients with these challenging tumors.

Deep learning-based fully automated differential diagnosis of eyelid basal cell and sebaceous carcinoma using whole slide images.

BackgroundThe differential diagnosis of eyelid basal cell carcinoma (BCC) and sebaceous carcinoma (SC) is highly dependent on pathologist’s experience. Herein, we proposed a fully automated differential diagnostic method, which used deep learning (DL) to accurately classify eyelid BCC and SC based on whole slide images (WSIs).MethodsWe used 116 haematoxylin and eosin (H&E)-stained sections from 116 eyelid BCC patients and 180 H&E-stained sections from 129 eyelid SC patients treated at the Shanghai Ninth People’s Hospital from 2017 to 2019. The method comprises two stages: patch prediction by the DenseNet-161 architecture-based DL model and WSI differentiation by an average-probability strategy-based integration module, and its differential performance was assessed by the carcinoma differentiation accuracy and F1 score. We compared the classification performance of the method with that of three pathologists, two junior and one senior. To validate the auxiliary value of the method, we compared the pathologists’ BCC and SC classification with and without the assistance of our proposed method.ResultsOur proposed method achieved an accuracy of 0.983, significantly higher than that of the three pathologists (0.644 and 0.729 for the two junior pathologists and 0.831 for the senior pathologist). With the method’s assistance, the pathologists’ accuracy increased significantly (P<0.05), by 28.8% and 15.2%, respectively, for the two junior pathologists and by 11.8% for the senior pathologist.ConclusionsOur proposed method accurately classifies eyelid BCC and SC and effectively improves the diagnostic accuracy of pathologists. It may therefore facilitate the development of appropriate and timely therapeutic plans.

Periocular basal cell carcinoma results and surgical outcome during a 5-year period in a larger Danish population

BackgroundTo report tumour pathology, surgical procedure, complication rates and overall outcome of periocular basal cell carcinoma (BCC) in the Department of Ophthalmology at Sygehus Lillebaelt, Southern Denmark Region over a 5-year period.MethodsMedical records for all patients who underwent surgery for periocular BCC between January 2016 and December 2020 were reviewed. All tumours were excised with a 3 mm margin beyond the clinically apparent delimitation of the tumour and analysed by frozen section histological examination. Paraffin sections were subsequently examined for a final histopathological diagnosis. Patient age, gender, date of resection, former cancer history, referring unit and follow-up time were recorded. Furthermore, histological subtypes identified from biopsy and resection, lesion location, lesion diameter, free margin after the first operation, lacrimal punctum involvement, reconstructive techniques and complications were also recorded.ResultsA total of 242 surgical excisions from 237 patients were recorded. The mean age was 69.7 ± 12.6 with women significantly predominant compared to men (1.8:1, p < 0.0001, binomial test). The mean tumour diameter was 4.29 mm (range 0.5–20 mm). The most common location and histological subtype was the lower eyelid and nodular BCC respectively (64.9% and 74.0% of cases). In 17.4% of the patients, the initial resection margin on the frozen section histology was not free of tumour cells and the risk was significantly greater for BCC subtypes considered aggressive in terms of growth pattern (morphea form, infiltrative and micronodular features) as compared to non-aggressive BCC subtypes (nodular and superficial) (p = 0.002, X2). In 239 (98.8%) of the patients, the BCC was found to be radically removed after final histopathological examination.The sensitivity of identification of aggressive subtypes of periocular BCC in biopsies was 47.7%. No recurrences were found during the 5-year period.ConclusionThis study demonstrated a tendency towards more women than men being diagnosed with periocular BCC. The initial biopsy performed for all patients underestimated the aggressiveness of BCC in almost half of the cases while aggressive BCC subtypes were more likely to need further resection after frozen section compared to non-aggressive subtypes.

Characteristics of Malignant Eyelid Basal Cell Carcinoma in Dr. Mohammad Hoesin General Hospital: A Retrospective Study

Introduction: Incidence rates of skin cancer have risen significantly over the last two decades. Most tumors develop in sun-exposed areas of the head and neck. Basal cell carcinoma (BCC) rarely metastasizes but can cause significant morbidity and death due to direct spread to the orbit, head, and neck and frequent recurrence. In addition, approximately 40% of BCC patients have other lesions after 5 years. Although there has been a lot of epidemiological data regarding the characteristics of BCC in developed countries, reports of BCC in Asia, especially in Southern Sumatra, are still at a minimum rate.&#x0D; Methods: This study retrospectively reviewed the medical records specific to periocular BCC. Data were collected from the patient register book recorded from January 2021 to May 2022. The clinical characteristics of patients with BCC, such as gender and age, clinicopathological findings of BCC lesions, and BCC management, were reviewed retrospectively. This study aims to determine the epidemiological profile of the malignant eyelid BCC patient, the BCC lesion characteristics, and the management of BCC cases at Mohammad Hoesin General Hospital Palembang.&#x0D; Results: From 16 BCC patients recruited for this study, most of them were 51–60 years old and 71–80 years old, each with 5 patients (31.3%). The female preponderance of 56.3%. Occulus dextra (56.3%), lower eyelid (62.5%), T1 (87.5%), nodular BCC (75,0%), and primary lesion (75,0%) were the most side, periocular site, size, histopathological subtype and recurrence, respectively. Most therapy done is excision (93,8%), while the leading reconstructive technique was Tenzel’s flap (50,0%).&#x0D; Conclusion: There is a slight preponderance of females as BCC patients. BCC is commonly found in elderly people. The lower eyelid and right side are the most frequent anatomical locations. Nodular is the most common histological subtype. In addition, lesions often present in T1 size and primary lesions. Lastly, the treatment is mainly surgical (excision), with Tenzel's flap as the most used reconstruction technique option.

Dermoscopy as an Aid in the Differentiation of Recurrent Eyelid Basal Cell Carcinoma Versus apocrine Hidrocystoma.

Dermoscopy as an Aid in the Differentiation of Recurrent Eyelid Basal Cell Carcinoma Versus apocrine Hidrocystoma.

Atypical Recurrent Presentation of Histologically Aggressive Type of Basal Cell Carcinoma with a Challenging Management- A Rare Case Report

Basal Cell Carcinoma (BCC) is the most common type of eyelid malignancy among white race individuals but is rare among blacks and Indians. BCC predominantly affects the sun exposed parts like the neck, back and face (88-90%). These tumours are mostly located on the lower eyelid margin and the medial canthus as upper eyelids are protected from the Ultraviolet (UV) sunrays by the eyebrows and superior orbital margin. Although BCC seldom metastasizes, it is nonetheless considered malignant, since it can infiltrate adjacent tissues and cause substantial deformity and destruction. Here, authors have reported a rare case of 55-year-old female patient with recurrence of surgically treated BCC of upper eyelid involving eyebrow. Surgical excision is the most common employed treatment of choice in extensive tumours. Patient had extensive recurrent spread of BCC in left upper eyelid with multiple small ulcers in and around the left eye with pain and no Perception of Light (PL) vision. Exenteration of left eye was done followed by split skin autografting at the site. BCC is usually not fatal, but early diagnosis and appropriate treatment promises better functionality and aesthetic outcome.