Basal Cell Carcinoma

Patients with basal cell carcinomas most commonly notice a reddish nodule slowly forming on their eyelid. The tumor is most commonly found on the lower eyelid, followed by the medial canthus and may also occur on the upper eyelid. Eyelash loss around the tumor suggests that a basal cell carcinoma is malignant.

Less commonly, basal cell cancers can be pigmented or present without any nodule at all. When the tumor does not make a nodule and grows within the eyelid, it can induce pulling of the eyelid . This form of basal cell carcinoma “morpheaform,” is much more difficult to cure because its edges are harder to define.

DIAGNOSIS

Though small tumors can be photographed and followed for evidence of growth (prior to biopsy); once the eye cancer specialist suspects basal cell carcinoma, most eye cancer specialists will suggest tumor biopsy. This specimen is sent to the pathologist to confirm the diagnosis prior to complete removal or treatment of the tumor. Biopsies can be performed in the doctor’s office, or in the operating room prior to definitive treatment.

TREATMENTS

Once the diagnosis is confirmed by the pathologist, treatment is recommended. Wedge resection and Moh’s surgery require the Eye surgeon continue to remove the tumor until the margins (edges) are negative, i.e.,free of tumor. Unlike most skin, the eyelids are a complex functional apparatus that requires special reconstruction techniques.

Most basal cell carcinomas are cured when they are small. Unfortunately, some patients choose to ignore or deny the existence of these tumors. Those patients allow their tumor to invade behind the eyeball and that becomes difficult or impossible to remove. In these cases, combinations of surgery, radiation and chemotherapy may be required to control or destroy the tumor.

PREVENTION

1. Protect against UV rays 2. Stay in the shade 3. Apply sunscreen, High SPF, water resistant 4. Cover up, clothing can provide a great barrier against the sun’s UV rays. Clothing protection is consistent over time and does not wear off like sunscreen does.

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Author

Paddy Kalish OD, JD and B.Arch

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