Basal Cell Carcinoma Of Eyelid Research Articles

Social Challenges of Cancer Patients With Orbitofacial Disfigurement

Patients who undergo orbital exenteration often experience social problems because of their facial disfigurement. The authors studied the interaction of cancer patients who had undergone orbital exenteration with family members and friends (primary groups) and with acquaintances and strangers (secondary groups) in small and large groups. In-depth telephone interviews were conducted with 12 patients treated at a cancer center (7 men and 5 women aged 51-81 years) and 12 family members (8 spouses and 4 children or siblings). Three patients had adenoid cystic carcinoma of lacrimal gland, 3 had squamous cell carcinoma of conjunctiva/eyelid, and 1 each had conjunctival melanoma, eyelid sebaceous gland carcinoma, transitional cell carcinoma of lacrimal sac, adenocarcinoma of orbit, neuroendocrine carcinoma of orbit, and basal cell carcinoma of eyelid. Time from orbital exenteration to interview ranged from 8 months to 36 years (median, 44 months). Two patient groups were identified according to comfort in interactions with acquaintances and strangers. Always comfortable patients were always at ease. Occasionally comfortable patients were at ease in large groups in situations of "benign neglect" and in small groups when they received "sympathy"; were uncomfortable in large and small groups when episodes of "intrusion" occurred; and had mixed responses to benign neglect in small groups and sympathy in large groups. Both patient groups felt comfortable with family members and friends. Patients who will undergo orbital exenteration should be warned about possible difficulties with social interactions. Healthcare personnel should be trained to help patients and family members prepare for such difficulties.

Correlation and expression of COX-2 and P53 protein in basal cell carcinoma of eyelid

The correlation between the expression of COX-2 and p53 protein in basal cell carcinoma (BCC) of eyelid and apoptosis was investigated. Specimens of BCC were collected from 40 cases (aged 28-68 y) at the Department of Pathology, Renmin Hospital of Wuhan University, and Department of Pathology, Zhongnan Hospital of Wuhan University during from 1999 to 2006. Five specimens of paracancerous tissues served as control group. Immunohistochemical staining was performed to detect the expression of COX-2 and p53 in the tissues. The average absorbance (A) and the average positive area rate of COX-2 and p53 protein were measured by image analysis. The positive area rate of COX-2 and p53 protein was analyzed by linear correlation analysis. It was found that COX-2 and p53 proteins were highly expressed in BCC of eyelid, and weakly expressed in paracancerous tissues. Image analysis revealed that the expression of COX-2 and p53 proteins in BCC of eyelid was significantly higher than that in paracancerous tissues (P<0.01). Spearman rank correlation analysis demonstrated a positive correlation between the expression of COX-2 and p53 (r=0.113, P=0.421). It was concluded that COX-2 can increase the expression of p53 protein, therefore suppressing apoptosis.

Incidence of eyelid malignancies in Varna region

Aim: To study the incidence of malignant eyelid tumors and particularly of eyelid basal cell carcinoma in Varna region between 1996 and 2005. Material and Methods: Data for the incident eyelid cancer cases were obtained from the Regional Cancer Dispensary and the patient register of the Specialized Eye Hospital in Varna. The data for the numbers of the population of Varna district at risk were received from the local office of the National Statistical Institute. The age standardized rates were derived by the direct method using the "world" standard population. Results: The average age-adjusted incidence for all malignant eye lid tumors was 3.47 per 100 000 per year, for BCC 3,02 per 100 000. The age-adjusted malignant eyelid tumor incidence for females was 2.9 per 100 000, in male it was significantly higher - 4.25 per 100 000. The age adjusted incidence for all malignant eyelid tumors among the urban and rural population were respectively 3.49 per 100 000 and 2.91 per 100 000. Conclusion: The incidence of all malignant eyelid tumors and BCC has increased for the period 1996-2005. There is a statistically significant difference in rates between sexes, men suffering more often than women. Incidence increases with age, especially after 60 years. Scripta Scientifica Medica 2009; 41(1): 35-38.

Photodynamic therapy of eyelid basal cell carcinoma

Photodynamic therapy (PDT; i.e. selective destroying of malignant cells by exposing them to red light after photosensitization) has been increasingly used for non-melanoma skin cancers. Due to excellent cosmetic and functional results, especially in difficult-to-treat areas, it may offer a comprehensive alternative to previous treatment modalities. A series of six patient cases was used to evaluate the efficacy of PDT in the treatment of lower eyelid basal cell carcinoma (BCC). Methods Histological confirmation of BCC, a detailed demonstration of the technique with an illustrative series of cases and a review of related literature. Six patients with lower eyelid BCC were treated with two treatment sessions of PDT within a week. Five patients had a nodular type and one patient had a superficial type of BCC. The follow-up after treatment continued for 20-36 (mean 26.5) months. No recurrences were observed during the follow-up. All the patients were satisfied with the good results and tolerated the treatment well without any harm to the eyeball or surrounding skin. PDT, although experimental in the eyelid area because of the small amount of data and the lack of a long-term follow-up, may be considered a promising comprehensive alternative when treating BCC in the eyelid area.

Photodynamic Therapy Using Methyl Aminolevulinate Acid in Eyelid Basal Cell Carcinoma: A 5-Year Follow-up Study

To evaluate retrospectively the long-term results of methyl aminolevulinate photodynamic therapy for the treatment of eyelid basal cell carcinoma. Sixteen consecutive patients with eyelid basal cell carcinoma were treated with methyl aminolevulinate photodynamic therapy between January 2002 and April 2003. Selection criteria were tumors located at least 3 mm from the tarsus, surgery not indicated because of poor general health, and recurrences with unclear location definition. Patients were treated with an 80-J cm light-emitting diode light source (632 nm) after topical application of methyl aminolevulinate cream and occlusion for 4 hours. Data were available for follow-up at day 1, week 1, month 1, and every 6 months for 5 years. The mean number of photodynamic therapy session per patient was 3.1 (range, 2-6) Complete clinical recovery was observed after the 5-year follow-up in 13 of 16 patients (82%). Two patients did not respond at all to treatment and 1 patient presented with recurrence after 3 years of tumor-free follow-up. Tolerance of treatment was good with few side effects. The absence of complications, good tolerance, and a notable success rate make this nonsurgical procedure promising for the treatment of basal cell carcinoma of the eyelid in selected patients.

Outcomes of Excision of 1750 Eyelid and Periocular Skin Basal Cell and Squamous Cell Carcinomas by Modified En Face Frozen Section Margin-controlled Technique

Outcomes of Excision of 1750 Eyelid and Periocular Skin Basal Cell and Squamous Cell Carcinomas by Modified En Face Frozen Section Margin-controlled Technique

Basal Cell Carcinoma of the Eyelids and Periorbital Region in a Turkish Population

To review the clinical and histopathologic features, treatment, and outcomes of eyelid basal cell carcinomas. The clinical records and histopathologic specimens of 311 patients with eyelid basal cell carcinomas were reviewed and analyzed retrospectively. The main outcome measures are patient demographics, clinical characteristics, lesion size, duration of lesion, histologic subtypes, presence of orbital and perineural invasion, severity of peritumorous inflammation, treatment modalities, recurrence rate, tumor-related death, and prognostic features. Two-hundred ninety patients underwent surgery whereas others received radiotherapy or chemotherapy. The most common histologic subtypes were infiltrative, nodular, and basosquamous basal cell carcinomas. Nearly one-third (29.9%) of the patients were previously recurrent. Orbital and perineural invasion rates were 17.04% and 10.6%, respectively. Recurrent basal cell carcinomas were larger, with longer duration of lesion and a higher rate of orbital and perineural invasion. Basosquamous basal cell carcinomas were more likely to have prior recurrences, larger lesion size, and the highest rate of orbital invasion. Perineural invasion was most frequent in morpheaform and basosquamous subtypes. Peritumorous inflammation differed between subtypes and was highest in the superficial subtype. The recurrence rate was 7.39% in total. The death of 2 patients was tumor-related. In this large case series from a single center, the outcomes were worse than previously reported due to delay in treatment and previous inadequate treatments. Adverse prognostic factors associated with secondary orbital invasion are previous recurrences, aggressive histologic subtypes, longer duration of lesion, larger lesion size, and the presence of perineural invasion.

A technique for the reconstruction of lower eyelid marginal defects

Objectives:To report on a new one-step technique for the reconstruction of lower eyelid marginal defects.Method:Retrospective case series of 5 patients with lower eyelid basal cell carcinomas abutting the eyelid margin....

Imiquimod in the treatment of eyelid basal cell carcinoma

Imiquimod in the treatment of eyelid basal cell carcinoma

Imiquimod in the treatment of eyelid basal cell carcinoma

To assess the efficacy and safety of topical imiquimod 5% cream in the treatment of eyelid basal cell carcinoma. Four patients with eyelid basal cell carcinoma were treated with imiquimod once daily, 5 days per week, for 6 weeks. Tissue biopsy was taken and clinical examination with slit-lamp microscopy was performed at the beginning of the study and after a follow-up of 12 weeks. Photographic follow-up was performed from the baseline visit to 6, 12 and 26 weeks. In the 12-week follow-up after imiquimod treatment, histopathological tissue sample analysis showed no signs of basal cell carcinoma in any of the patients. The results indicate that 5% imiquimod cream with topical administration may represent a new therapy option for eyelid basal cell carcinoma.

Application of superficial temporal artery frontal branch island flap for repair of defect secondary to lower eyelid basal cell carcinoma

目的 探讨下睑基底细胞癌的治疗方法.方法 术前用超声多普勒测定并标记颞浅动脉及其额支的走行方向.术中距病损边缘0.5～1.0 cm切除病变组织,并送冰冻切片检查,以确定病变的性质及是否切除彻底.据术前标记设计额部皮瓣,皮瓣应大于缺损0.5 cm,蒂长大于蒂到缺损区1.0～1.5 cm,宽约3 cm.累及眼睑全层的缺损,将结膜游离后上拉与皮瓣缝合,或将皮瓣设计足够大,将皮瓣边缘修成全厚皮,翻转后与结膜缝合.供区创面较大,可考虑皮片移植修复.结果 本组5例,均行额部岛状皮瓣修复,术后无下睑缺损及外翻.结论 应用颞浅动脉额支岛状皮瓣修复下睑基底细胞癌切除后创面,效果良好。

Expression of p16 and CD44V6 in basal cell carcinomas of eyelid

目的 探讨眼睑基底细胞癌中肿瘤抑制基因p16和细胞黏附分子变异体6(CD44V6)表达及临床病理学意义.方法应用SABC(链霉亲和素-生物素-过氧化物酶复合物)免疫组织化学法对48例眼睑基底细胞癌中p16、CD44V6蛋白表达进行检测.结果48例眼睑基底细胞癌中p16、CD44V6蛋白阳性表达率分别为66.7%(32/48)和39.6%(19/48),分化型与未分化型p16、CD44V6蛋白阳性表达率差异有显著性(P＜0.05),CD44V6蛋白阳性表达率与肿瘤复发有关(P＜0.05).结论p16、CD44V6蛋白表达与眼睑基底细胞癌的分化程度有关,CD44V6分子可能与眼睑基底细胞癌的复发有关。

Supraestructure maxillectomy and orbital exenteration for treatment of basal cell carcinoma of inferior eyelid: Case report and review.

Basal cell carcinoma (BCC) is the most frequent type of skin cancer in humans, with cumulative exposure to ultraviolet radiation (UVR) as important risk factor for development of the illness as such as severe solar burns during childhood or adolescence. BCC is mainly located on sun exposed sites, being head and neck the areas of more incidence; although nose, eyelids and periorbitary tissue are unfavorable due to cosmetic results that BCC involves. Tumors can be classified as: nodular, superficial, micronodular, morphea variety, infiltrating, pigmented, metatypic and fibroepithelioma of Pinkus. Several treatment options as surgical and non-surgical are available. The goal of treatment is complete excision of the tumor with preservation of surrounding structures in a way aesthetically acceptable. Mohs' micrographic surgery is the standard treatment for all non-melanoma skin cancer. Orbital exenteration is also used for treatment of malignancies of ocular tissues, mainly squamous cell carcinoma, sebaceous cell carcinoma and BCC. The tissue beneath the surgical site can be left for second-intention granulation or covered with a cutaneous implant of partial thickness. The case of a 77 year-old patient is presented with BCC of inferior eyelid of 14 years duration, formerly managed with radiotherapy and, due to recurrent illness and invasion to the maxillary antrum; he needed supraestructure maxillectomy with left orbital exenteration.

The Australian Mohs database, part I: Periocular basal cell carcinoma experience over 7 years

Objective To present the findings of all patients with periocular basal cell carcinoma (BCC) treated with Mohs' micrographic surgery (MMS) in Australia between 1993 and 1999. Design Prospective, noncomparative, multicenter, interventional case series. Methods Prospective series of 1295 patients undergoing MMS for periocular BCC over a 7-year period (1993–1999). Inclusion criteria Periocular BCC referred for MMS. Main outcome measures Site, tumor size, prior occurrence, defect size, histologic subtype, and presence of perineural invasion. Results Twelve hundred ninety-five patients had 615 (47.5%) lower eyelid, 626 (48.3%) medial canthus, and 51 (3.9%) upper eyelid BCCs. The most common histologic subtypes were nodulocystic (39.5%) and infiltrating (34.8%) ( P = 0.0008). Sixty-eight percent were primary and 32% were recurrent tumors. Previously recurrent BCCs were larger ( P<0.0001), with larger defects ( P<0.0001) than primary BCCs, and had more subclinical extension ( P<0.0001) requiring more levels for complete excision ( P<0.0001). Furthermore, superficial BCCs were more likely to have a prior occurrence ( P<0.0001). In this series, perineural invasion was found in 1% of cases, with greater subclinical tumor extension in such cases ( P = 0.0657). Conclusion The Australian MMS database is the largest prospective, nationwide series of high-risk periocular BCC managed by MMS. Almost 50% of tumors were at the medial canthus, with nodulocystic and infiltrating being the most common histologic subtypes. Recurrent BCCs comprised a third of tumors and were larger, with larger defects and more subclinical extension than primary BCCs. Perineural invasion was found in 1% of cases and also had greater subclinical extension.

The Australian Mohs database, part II: Periocular basal cell carcinoma outcome at 5-year follow-up

Objective To report the outcome with 5-year strict follow-up (only cases where 5-year follow-up is available) of all patients with periocular basal cell carcinoma (BCC) treated with Mohs' micrographic surgery (MMS) in Australia between 1993 and 1996. Design Prospective, noncomparative, multicenter, interventional case series. Methods A prospective series of 819 patients, undergoing MMS for periocular BCC over a 3-year period (1993–1996). Inclusion criteria Periocular BCC referred for MMS. Main outcome measures Recurrence, site, size, prior occurrence, defect size, histologic subtype, and presence of perineural invasion. Results Eight hundred nineteen patients had 257 (54%) lower eyelid, 195 (41%) medial canthus, and 22 (5%) upper eyelid BCCs. The most common histologic subtypes were nodulocystic (43%) and infiltrating (30%) ( P = 0.0003). Sixty-eight percent were primary and 32% were recurrent tumors. Five-year follow-ups for cases between 1993 and 1996 were available in 347 (42%) cases. There were 7 recurrences (2.0%; exact 95% confidence interval [CI]: 0.82%–4.1%), 5 of which were at the medial canthus and all of which were previously recurrent, with up to 3 recurrences before MMS. Previous recurrence ( P<0.0001), infiltrating (5) or superficial (2) histologic subtype ( P = 0.0882), and medial canthal site were the main predictors of recurrence after MMS. There were no recurrences for primary BCC, and the 5-year recurrence for previously recurrent BCC was 7.8% (exact 95% CI: 3.2%–15.4%). Conclusion The Australian MMS database is the largest prospective nationwide series of periocular BCC managed by MMS. The strict 5-year recurrence rates of 0% and 7.8% for primary and recurrent tumors, respectively, confirm MMS as the treatment of choice for periocular BCC.

Fine needle aspiration cytology of eyelid sebaceous gland carcinoma and its differential diagnosis

To investigate the fine needle aspiration cytology (FNAC) features and differential diagnosis of eyelid sebaceous gland carcinoma. Four cases of eyelid sebaceous gland carcinoma diagnosed by FNAC were reported and confirmed by biopsy. Three of the cases were in early stages with tumor sizes smaller than 10 mm in diameter and without metastasis. The smears were stained by routine H & E and SudanIII methods. The cytologic findings were described and compared to corresponding histological features, and moreover, compared to chalazion, pilomatrixoma and eyelid basal cell carcinoma. Neither hemorrhage nor infection were found after the examination. Abundant cells were observed in the sebaceous carcinoma FNAC smears. Two types of tumor cells were found: one showed tumor cells differentiating toward sebaceous gland, with large pale cells and vacuolated cytoplasm, the other demonstrated poorly-differentiated cell with dark and irregular nuclei. Numerous vacuoles with inequality of size were found in cytoplasm or in background in all four cases, and the SudanIII stain showed that these vacuoles contained lipid. Some smears demonstrated cells with basaloid, fusiform or squamous features, corresponding to various histopathological types. In contrast, smears of chalazion displayed inflammatory granuloma, containing several types of inflammatory cells without malignant cells. Smears of pilomatrixoma were cellular with three cell populations, which included bland sheets of basaloid cells, nucleated basophilic cells and anucleated keratinized "ghost cells", along with calcific debris. The smears of basal cell carcinoma were typically less cellular, more tightly cohesive and had smaller clusters of uniform hyperchromatic basaloid cells without vacuolization in cytoplasm or background. Overall, the cytological features of eyelid sebaceous carcinoma were distinct from those of chalazion, pilomatricoma and basal cell carcinoma. FNAC is a safe and effective approach for the diagnosis of eyelid sebaceous carcinoma and lipid stain is useful in differential diagnosis. The application of FNAC may be important in reaching an early diagnosis and initial treatment of eyelid nodule.

High incidence of demodicidosis in eyelid basal cell carcinomas.

Although UV radiation is the major cause of basal cell carcinoma (BCC), local factors, such as chronic trauma, irritation, or inflammation, may also have some role in its etiopathogenesis. The pilosebaceous follicle mites, Demodex folliculorum and D. brevis, inhabit most commonly and densely certain facial skin areas, including the nose and periorbital regions, where BCC also develops most frequently. To investigate, in a retrospective histopathologic study, whether a possible etiopathogenetic relationship exists between demodicidosis and eyelid BCCs. We examined 32 eyelid BCC specimens that contained at least five eyelashes or five hair follicles with respect to the presence and density of Demodex mites. As controls, we evaluated 34 matched specimens consisting of benign eyelid skin lesions. Twenty-one of 32 BCC cases (65.6%) and eight of 34 control cases (23.33%) had demodicidosis. Mean mite counts were 1.31 +/- 1.57 and 0.47 +/- 0.99 in BCC cases and controls, respectively. The differences were significant for both prevalence (P < 0.001) and density (P = 0.0052). Although there was a significant positive correlation between increasing mite number and patient age in the control group (r = 0.47, P < 0.05), no significant correlation was found between these two factors in BCC cases (r = -0.102, P > 0.05). Demodicidosis may be one of the triggering factors of carcinogenesis in eyelid BCCs in otherwise predisposed people due to its traumatic/irritating effect or chronic inflammation.

Ocular Tumors in Animals and Humans

Edited by Robert L. Peiffer, Jr, and Kenneth B. Simons, 461 pp, with illus, Ames, Iowa, Iowa State Press, 2002.Ocular Tumors in Animals and Humans is an unusual book that attempts to provide a thorough review of ocular oncology in animals and humans in one text. In his preface to the text, Robert L. Peiffer, Jr, DVM, PhD, a veterinary ophthalmologist, indicates that his purpose in creating this text was to provide an enhanced understanding of ocular tumors through a comparative species approach. To accomplish this, he elicited the editorial assistance of Kenneth B. Simons, MD, an ophthalmologist and ophthalmic pathologist, and the expertise of 34 other veterinarians and physicians to bring together information on the broad range of ophthalmic tumors seen in animals and humans.In general, the text is well written, with extensive references. The more than 380 clinical illustrations and photomicrographs are of excellent quality, although all are in black and white. The text is organized into 14 chapters largely divided on an anatomic basis. For the most part, each chapter begins with a discussion of ocular tumors in animals for the tissue in question, followed by a similar discussion of ocular tumors in humans for the same tissue. The exceptions to this are chapters on the phakomatoses (disorders that are unique to humans), neoplasms of the lacrimal drainage system in humans, and feline ocular sarcomas, as well as a chapter on animal models of ophthalmic tumors. The chapter on retinoblastoma is also largely a discussion of human pathology, as spontaneous cases of retinoblastoma appear to be almost exclusively limited to humans. The remaining chapters include discussions of tumors of the orbit, eyelid, conjunctiva, cornea and sclera, uvea, and optic nerve. Separate chapters on ocular lymphoid proliferations and metastatic tumors are also provided.On average, the majority of information provided in the text is on human oncology, as the incidence of animal tumors is comparatively low, likely due to the inherent diagnostic difficulties in animals as compared with humans. The discussion of animal tumors is primarily limited to that of cats, dogs, horses, and cows. As an ophthalmologist and ophthalmic pathologist, I found the latter to be of interest from the perspective of comparative pathophysiology. Of particular curiosity was the rarity of eyelid basal cell carcinomas in animals as compared with humans (in whom it represents the most common malignant tumor of the eyelid), and the discussion of adenocarcinoma of the gland of the third eyelid and of feline ocular sarcomas. I found the text to be informative and valuable, although as compared with other already available texts on ocular tumors in humans, there are arguably more extensive and complete discourses on the topic available. This text will be of interest primarily to veterinary ophthalmologists, ophthalmic pathologists, and ocular oncologists. Researchers in the area of ocular oncology will find the last chapter on animal models of particular interest.

Epidemiology of basal cell carcinoma of the eyelid in south-western Finland.

Basal cell carcinoma (BCC) is the most common malignant tumour of the skin in Caucasians. It often appears on the eyelids but there are no population-based studies on the incidence of BCC of the eyelid in Nordic countries. The mean annual incidence rates of BCC of the eyelid in the region of South-Western Finland from 1977 to 1997 were calculated. The mean annual incidence (per 100,000 population) of BCC of the eyelid showed a statistically significant increase from 0.82 (in 1977-1979) to 2.88 (in 1995-1997). The incidence of BCC of the eyelid was 0.8 in the age group of 30-49 years and rose significantly with age (P < 0.0005) to the maximum of 17.2 in the age group of 80-89 years. There were no statistically significant differences in the incidence rates of BCC of eyelid between males and females or between urban, semi-urban and rural populations. In South-Western Finland the incidence of BCC of the eyelids more than tripled during the years from 1977 to 1997. This may be due to the increase of the elderly population, because the incidence showed a significant increase with age.

Mohs' micrographic surgery for basal cell carcinomas on the eyelids and medial canthal area. I. Characteristics of the tumours and details of the procedure.

To analyse the characteristics of eyelid basal cell carcinomas excised using Mohs' micrographic technique. Sixty-six eyelid basal cell carcinomas were excised using Mohs' micrographic technique. The tumours were classified into four subtypes; morpheiform, intermediate, nodular/micronodular and superficial. Data on previous treatment of the tumours were retrieved. Thirty-two tumours (48%) were primary, 8 tumours (12%) were incompletely excised using conventional excision surgery and 26 tumours (39%) were recurrent. Nineteen of the 26 (73%) recurrent tumours and 14 of the 32 (44%) primary tumours were nodular/micronodular. To achieve radical excision, superficial tumours needed an average of 2.0, nodular/micronodular 2.5, intermediate 2.0 and morpheiform tumours 2.9 excisions. Eyelid basal cell carcinomas with ill-defined borders or recurrent tumours are well suited for Mohs' micrographic surgery. The extensions of the tumours are difficult to determine even in some less aggressive subtypes such as superficial and nodular/micronodular basal cell carcinomas.