Post on 24-Dec-2015
BCC Eyelids
• Mrs. X 80/F• Ulcer over left upper eyelid 8 months• Loss of vision in left eye – 4 months• Past H/O surgery for BCC 2 years back - excision O/E – No nodes
Dx- Recurrent BCC Lt Upper Eyelid
MALIGNANT EYELID TUMOURS
1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Meibomian gland carcinoma
4. Melanoma
5. Kaposi sarcoma
6. Merkel cell carcinoma
7. Treatment
Basal Cell Carcinoma - Important Facts
1. Most common human malignancy
2. Usually affects the elderly
3. Slow-growing, locally invasive
5. 90% occur on head and neck
6. Of these 10% involve eyelids
7. Accounts for 90% of eyelid malignancies
4. Does not metastasize
Frequency of location of basal cell carcinoma
Lower lid - 70% Medial canthus - 15%
Upper lid - 10% Lateral canthus - 5%
Nodular basal cell carcinomaEarly
• Shiny, indurated nodule• Surface vascularization
• Slow progression
Advanced
• May destroy large portion of eyelid
Ulcerative basal cell carcinoma(rodent ulcer)
Early
Chronic ulceration
Advanced
Raised rolled edges and bleeding
Sclerosing basal cell carcinoma
• Indurated plaque with loss of lashes
Advanced
• Spreads radially beneath normal epidermis
Early
• May mimic chronic blepharitis • Margins impossible to delineate
Histology of basal cell carcinoma
Downgrowth from epidermisof small, dark atypical basal cells
Peripheral palisading
Cell nests in fibrous stroma
Treatment Options
3. Cryotherapy
2. Radiotherapy• Small BCC not involving medial canthus
1. Surgical excision• Method of choice
• Small and superficial BCC irrespective of location
• Adjunct to surgery in selected cases