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RECURRENT PERIOCULAR BASAL CELL CARCINOMA. CASE REPORT


Authors: Z. Prídavková 1,2;  A. Bieliková 1;  N. Ferková 1;  D. Lysková 2
Authors‘ workplace: Klinika oftalmológie, Ústredná vojenská nemocnica SNP Ružomberok – FN, Ružomberok 1;  Klinika oftalmológie LF UK a UN Bratislava, Nemocnica Ružinov 2
Published in: Čes. a slov. Oftal., 77, 2021, No. 4, p. 208-213
Category: Case Report
doi: https://doi.org/10.31348/2021/24

Overview

Aim: We present the management of a severe case of recurrent periocular basal cell carcinoma, orbital invasion and exenteration.

Case report: The present case is of a recurrent basal cell carcinoma in a 84-year-old male presenting with non-healing lesion above right eyelid. A tumor excision was performed in May 2014. Histopathology revealed a basal cell carcinoma (dg. C44.1 ICD-10-CM) with positive margins. The re-excision of the lesion was performed. After two years, there was a local 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, a recurrence of the tumor was once again noted. Histopathology revealed a basal 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, a progression of the local finding was noted.

Conclusion: 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 a relatively small percentage of invasive diseases today, advanced stages may still occur; either as a result of the patient's late 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.

Keywords:

basal cell carcinoma – periocular tumors – tumors eyelashes – orbital exenteration


Sources
  1. Silverman N, Shinder R. What‘s New in Eyelid Tumors. Asia Pac J Ophthalmol (Phila). 2017 Mar-Apr;6(2):143-152.
  2. Furdová A, Oláh Z. Nádory oka a okolitých štruktúr. Brno: Akademické nakladatelství CERM; 2010. 152 p.
  3. Ondrušová M, Pleško I, Safaei-Diba Ch, et al. Komplexná analýza výskytu a úmrtnosti na zhubné nádory v Slovenskej republike [Internet]. Bratislava: Národný onkologický register SR; 2007. Avaiable from: http: www.nor-sk.org
  4. Furdová A, Horkovičová K, Babál P, et al. Nemelanómové nádory kože mihalníc a vnútorného kútika - bazocelulárny karcinóm [Non-melanotic Tumors of the Eyelids Skin and Inner Corner - Basocellular Carcinoma]. Cesk Slov Oftalmol. 2015 Winter;71(6):293-301. Slovak.
  5. Furdova A, Lukacko P. Periocular Basal Cell Carcinoma Predictors for Recurrence and Infiltration of the Orbit. J Craniofac Surg. 2017 Jan;28(1):e84-e87.
  6. Nemet AY, Deckel Y, Martin PA, et al. Management of periocular basal and squamous cell carcinoma: a series of 485 cases. Am J Ophthalmol. 2006 Aug;142(2):293-297.
  7. Shinder R. Risk factors for orbital exenteration in periocular basal cell carcinoma. Am J Ophthalmol. 2012 Jul;154(1):212-213.
  8. Cook BE Jr, Bartley GB. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota. Ophthalmology. 1999 Apr;106(4):746-750.
  9. Marzuka AG, Book SE. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med. 2015 Jun 1;88(2):167-179.
  10. Weesie F, Naus NC, Vasilic D, et al. Recurrence of periocular basal cell carcinoma and squamous cell carcinoma after Mohs micrographic surgery: a retrospective cohort study. Br J Dermatol. 2019 May;180(5):1176-1182.
  11. Leibovitch I, McNab A, Sullivan T, et al. Orbital invasion by periocular basal cell carcinoma. Ophthalmology. 2005 Apr;112(4):717-723.
  12. Paavilainen V, Tuominen J, Aho VV, et al. Long-term results after treatment of basal cell crcinoma of the eyelid in South-Western Finland. Eur J Ophthalmol. 2007 Jul-Aug;17(4):494-500.
  13. Sigurdsson H, Agnarsson BA. Basal cell carcinoma of the eyelid. Risk of recurrence according to adequacy of surgical margins. Acta Ophthalmol Scand. 1998 Aug;76(4):477-480.
  14. Poignet B, Gardrat S, Dendale R, et al. Basal cell carcinomas of the eyelid: Results of an initial surgical management. J Fr Ophtalmol. 2019 Dec;42(10):1094-1099.
  15. Furdova A, Kapitanova K, Kollarova A, et al. Periocular basal cell carcinoma - clinical perspectives. Oncol Rev. 2020 Apr 30;14(1):420.
  16. Smeets NW, Kuijpers DI, Nelemans P, et al. Mohs‘ micrographic surgery for treatment of basal cell carcinoma of the face-results of a retrospective study and review of the literature. Br J Dermatol. 2004 Jul;151(1):141-147.
  17. Bhatnagar A. Nonmelanoma skin cancer treated with electronic brachytherapy: results at 1 year. Brachytherapy. 2013 Mar-Apr;12(2):134-140.
  18. Furdová A, Lukačko P, Lederleitner D. HDR 192Ir brachyterapia v liečbe bazocelulárneho karcinómu dolnej mihalnice a vnútorného kútika oka - naše skúsenosti [HDR 192Ir brachytherapy in treatment of basal cell carcinoma of the lower eyelid and inner angle - our experience]. Cesk Slov Oftalmol. 2013 Jun;69(2):75-79. Slovak.
  19. Svetlosáková Z, Halás M, Krásnik V, et al. Výskyt recidív po chirurgickej liečbe bazaliómu kože mihalníc [Basalioma of the eyelid: rate and factors of recurrence after surgical therapy]. Cesk Slov Oftalmol. 2010 Oct;66(4):171-175. Slovak.
  20. Coker DD, Elias EG, Viravathana T, et al. Chemotherapy for Metastatic Basal Cell Carcinoma. Arch Dermatol. 1983; 119(1):44-50.
  21. Demirci H, Worden F, Nelson CC, et al. Efficacy of Vismodegib (Erivedge) for Basal Cell Carcinoma Involving the Orbit and Periocular Area. Ophthalmic Plast Reconstr Surg. 2015 Nov-Dec;31(6):463-466.
  22. Eiger-Moscovich M, Reich E, Tauber G, et al. Efficacy of Vismodegib for the Treatment of Orbital and Advanced Periocular Basal Cell Carcinoma. Am J Ophthalmol. 2019 Nov;207:62-70.
  23. Gill HS, Moscato EE, Chang AL, et al. Vismodegib for periocular and orbital basal cell carcinoma. JAMA Ophthalmol. 2013 Dec;131(12):1591-1594.
  24. Furdová A, Horkovičová K, Krčová I, et al. Exenterácia očnice pre bazocelulárny karcinóm [Exenteration of the Orbit for Basal Cell Carcinoma]. Cesk Slov Oftalmol. 2015 Aug;71(4):209-216. Slovak.
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