Comment Re: ‘Treatment of basal cell carcinoma with surgical excision and perilesional interferon-α’

AimsThe aim is to study staged periocular basal cell carcinoma (BCC) excision in a tertiary oculoplastic referral centre in Sheffield, UK. In particular, we examined patients with close or positive margins and no tumour seen on re-excision to identify demographics and tumour characteristics in this population.MethodsA retrospective review of medical records of 437 cases of staged periocular BCC excisions over a 10-year period (2007–2017) was carried out. Patients had surgical excision with 3 mm clinically clear margins. Staged excision was performed for all cases included in this study. Standard reconstruction techniques were employed. Histopathology was analysed for tumour type, subtype and stage.ResultsOver the 10-year period, of the 437 periocular BCCs, 156 had close or involved margins. Residual tumour was found in 29 (18.6%), whereas in 122 eyelids of 120 patients (78.2%) no residual tumour was identified on histological examination. Micronodular (54.1%) and nodular (23.7%) growth patterns of BCC, as well as lower eyelid location (72.1%), were the most prevalent in this population. Two patients (1.6%) had recurrence of BCC over a mean follow-up of 57 months (range 1–125 months).ConclusionsA significant proportion of BCCs transected on initial excision show no residual tumour in the re-excision specimens. In the interval between initial excision and re-excision, there may be eradication of the residual tumour. The exact mechanisms for this are unclear, however, and re-excision remains the appropriate recommended course in the presence of involved surgical margins of periocular BCC, particularly when high-risk tumour subtypes are encountered.

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Mohs micrographic surgery versus surgical excision for periocular basal cell carcinoma

10.1002/14651858.cd007041.pub3 ◽

2012 ◽

Cited By ~ 4

Author(s):

Krishnamoorthy Narayanan ◽

Omar H Hadid ◽

Eric A Barnes

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Mohs Micrographic Surgery ◽

Micrographic Surgery

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The Cost-Effectiveness of MOHS Micrographic Surgery Versus Surgical Excision in Basal Cell Carcinoma

Plastic & Reconstructive Surgery ◽

10.1097/01.prs.0000388804.15361.16 ◽

2010 ◽

Vol 126 ◽

pp. 82-83 ◽

Cited By ~ 1

Author(s):

Anup Patel ◽

Gary Price ◽

Elisa F. Long ◽

Stephan Ariyan

Keyword(s):

Cost Effectiveness ◽

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Mohs Micrographic Surgery ◽

Micrographic Surgery ◽

The Cost

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Standard surgical excision and reconstruction of giant basal cell carcinoma of the face: may be an alternative to the Mohs micrographic surgery

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.12360 ◽

2014 ◽

Vol 28 (11) ◽

pp. 1572-1573 ◽

Cited By ~ 1

Author(s):

M. Tuerdi ◽

A. Yarbag ◽

A. Maimaiti ◽

A. Mijiti ◽

A. Moming

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Basal Cell ◽

Surgical Excision ◽

Mohs Micrographic Surgery ◽

Micrographic Surgery ◽

The Face ◽

Giant Basal Cell Carcinoma

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Metastatic Basal Cell Carcinoma: A Biological Continuum of Basal Cell Carcinoma?

Case Reports in Dermatological Medicine ◽

10.1155/2012/157187 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4

Author(s):

Karaninder S. Mehta ◽

Vikram K. Mahajan ◽

Pushpinder S. Chauhan ◽

Anju Lath Sharma ◽

Vikas Sharma ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Basal Cell ◽

Neck Region ◽

Surgical Excision ◽

Axillary Lymph Nodes ◽

Axillary Lymph ◽

Metastatic Basal Cell Carcinoma ◽

Treat All

Basal cell carcinoma (BCC) accounts for 80% of all nonmelanoma skin cancers. Its metastasis is extremely rare, ranging between 0.0028 and 0.55 of all BCC cases. The usual metastasis to lymph nodes, lungs, bones, or skin is from the primary tumor situated in the head and neck region in nearly 85% cases. A 69-year-old male developed progressively increasing multiple, fleshy, indurated, and at places pigmented noduloulcerative plaques over back, chest, and left axillary area 4 years after wide surgical excision of a pathologically diagnosed basal cell carcinoma. The recurrence was diagnosed as infiltrative BCC and found metastasizing to skin, soft tissue and muscles, and pretracheal and axillary lymph nodes. Three cycles of chemotherapy comprising intravenouscisplatin (50 mg) and 5-florouracil (5-FU, 750 mg) on 2 consecutive days and repeated at every 21 days were effective. As it remains unclear whether metastatic BCC is itself a separate subset of basal cell carcinoma, we feel that early BCC localized at any site perhaps constitutes a biological continuum that may ultimately manifest with metastasis in some individuals and should be evaluated as such. Long-standing BCC is itself potentially at risk of recurrence/dissemination; it is imperative to diagnose and appropriately treat all BCC lesions at the earliest.

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