Anatomical and psychological limits in microscopically controlled excision of basal cell carcinomas of the medial canthus

Objectives. We set out to demonstrate that medial canthus tumors are malignancies requiring microscopically-controlled excision for a high cure rate. We also aim to show that reconstruction can have good esthetic results with a few simple techniques. Methods. During 1992, we treated 38 basal cell carcinomas of the medial canthus, employing our own two-step Mohs’ surgery. All cases were reconstructed with five simple techniques: “laissez faire”, full thickness graft, nasoglabellar flap, mild-line forehead flap or combination of flaps. Results. No recurrent basal cell carcinomas have been observed in our patients during the last four years. All the medial canthus tumours were basal cell carcinomas, eight involving morpheiform infiltration. Perineural infiltration was observed in two cases. Conclusions. Micrographic surgery for medial canthus malignant tumors is the best resection technique. Infiltrating, basal cell carcinomas, are the most common tumors of medial canthus, but also have an excellent cure rate. Reconstruction with a small number of flaps and skin graft is generally an easy process, producing highly satisfactory results.

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Evaluating radiotherapy in basal cell carcinomas of the medial canthus

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2012.12.665 ◽

2013 ◽

Vol 68 (4) ◽

pp. AB160

Keyword(s):

Basal Cell ◽

Medial Canthus ◽

Basal Cell Carcinomas

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A multicentre review of the histology of 1012 periocular basal cell carcinomas

European Journal of Ophthalmology ◽

10.1177/1120672120957597 ◽

2020 ◽

pp. 112067212095759

Author(s):

Zhiheng Lin ◽

Umair Qidwai ◽

Laszlo Igali ◽

Bridget Hemmant

Keyword(s):

Basal Cell ◽

Perineural Invasion ◽

Difficult Case ◽

Medial Canthus ◽

Surgical Specialty ◽

Complete Excision ◽

Incomplete Excision ◽

Basal Cell Carcinomas ◽

Deep Margin ◽

Excision Rate

Aims: To evaluate primary periocular basal cell carcinomas (BCCs) in depth including comparing histological margins with subtype, location and surgical specialty after wide local excision. Methods: A retrospective review was performed for all BCCs excised from three hospitals over 5 years, covering a population of just over 1 million. Tumours were classified according to histological subtype location. Incomplete excision rates and margins were analysed in detail and comparisons made. Results: The most common subtype found was nodular followed by infiltrative. Lesions were most commonly located at the lower lid. Infiltrative BCCs were associated with perineural invasion and incomplete excision despite the largest peripheral margins. Superficial BCCs had the smallest mean peripheral margin but the largest mean deep margin. 2 mm histological margins gave an 83.7% complete excision rate, 6.4% incomplete excision rate and 7.1% where the clearance margin was 0.3 mm or less. Conclusion: Distribution of eyelid BCCs based on subtype and periocular location mirrored the general consensus. Infiltrative BCCs should be excised with wider margins or referred for Mohs surgery, especially if the medial canthus is involved. Superficial BCCs should be excised with wider but shallower surgical margins. Ophthalmologists were more likely than dermatologists or plastic surgeons to incompletely excise a periocular BCC, which is reflective of their more difficult case mix.

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Radiotherapy for Basal Cell Carcinomas of the Medial Canthus

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2008.06.1327 ◽

2008 ◽

Vol 72 (1) ◽

pp. S419

Author(s):

E.L. Swanson ◽

C.G. Morris ◽

J. Kirwan ◽

W.M. Mendenhall ◽

R.J. Amdur

Keyword(s):

Basal Cell ◽

Medial Canthus ◽

Basal Cell Carcinomas

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The use of forehead flaps in the management of large basal cell carcinomas of the medial canthus/medial lower eyelid in Saudi patients

Saudi Journal of Ophthalmology ◽

10.1016/j.sjopt.2013.07.005 ◽

2013 ◽

Vol 27 (3) ◽

pp. 223-225 ◽

Cited By ~ 4

Author(s):

Nourhan A. Elshamma ◽

AlMaha Al Qabbani ◽

Hind M. Alkatan ◽

Mohammad M. Al-Qattan

Keyword(s):

Basal Cell ◽

Lower Eyelid ◽

Medial Canthus ◽

Basal Cell Carcinomas ◽

Saudi Patients

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Does incomplete excision of basal cell carcinoma of the eyelid mean tumor recurrence?

Anais Brasileiros de Dermatologia ◽

10.1590/s0365-05962010000600014 ◽

2010 ◽

Vol 85 (6) ◽

pp. 872-877 ◽

Cited By ~ 4

Author(s):

Irena Jankovic ◽

Predrag Kovacevic ◽

Milan Visnjic ◽

Dimitrije Jankovic ◽

Ivana Binic ◽

...

Keyword(s):

Basal Cell Carcinoma ◽

Cell Carcinoma ◽

Recurrence Rate ◽

Basal Cell ◽

Tumor Recurrence ◽

Medial Canthus ◽

Younger Patients ◽

Tumor Excision ◽

Basal Cell Carcinomas ◽

The Relationship

INTRODUCTION: Basal cell carcinoma is the most common tumor of the eyelid. In this region, reconstruction is complex and damage to healthy tissue should be minimal. Objective: To define the relationship between margin clearance at excision and the recurrence rate of basal cell carcinoma of the eyelid. METHODS: This prospective study was conducted with 111 patients submitted to surgery for basal cell carcinoma of the eyelid between 2001 and 2003 and followed up for a period of five years. The patients were evaluated according to age, tumor site, recurrence rate and margin clearance at excision. RESULTS: No significant association was found between incomplete tumor excision and recurrence except in patients under 56 years of age, female patients and in the case of tumors of the medial canthus. CONCLUSION: A risk of recurrence in incompletely excised basal cell carcinomas of the eyelid was only confirmed in younger patients, females and for tumors of the medial canthus.

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