Primary basosquamous carcinoma of the lower eyelid with ocular invasion

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COD: 2826_26_03_2018_EP Categorie: , ,

Georgios Ouilson Papadopoulos, Eleni Charitonidi, Nikolaos Filippou,
Domna Fanidou, Dimitrios Filippou, Panagiotis Scandalakis

Ann Ital Chir, Digital Edition 2018, 7
Epub, March 26

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Ocular invasion is extremely rare for a primary eyelid Basosquamous Carcinoma (BSC). It can however
occur in neglected cases if the clinical signs are overseen and the BSC is misdiagnosed for a less aggressive skin carcinoma.
MATERIALS AND METHODS: A 58-year-old man suffering from an inferior eyelid BSC that had been neglected for 7
years was referred to our clinic. A local infiltration of the maxillary sinus and the contents of the orbit by the tumor
was discovered, and he was managed with a left orbital exenteration and resection of the involved orbital bone. A follow
up was established.
DISCUSSION: BSC is a rare type of skin malignancy which as an entity rests between Basal Cell Carcinoma (BCC) and
Squamous Cell Carcinoma (SCC), and its aggressive nature is often greater than that of the BCC and the SCC. Having
no specific clinical features differentiating it from other BCC types, it can only be diagnosed by an adequate biopsy. Its
early diagnosis is crucial in diminishing it’s recurrence rate and it’s metastatic potential. The standard therapeutical
approach is the complete excision of the tumor, best performed by Mohs micrographic surgery. In cases of ocular infiltration,
orbital exenteration is also usually necessary.
CONCLUSIONS: Suspect, rapidly growing skin lesions should alert clinicians and an adequate biopsy should be performed.
Regarding BSC, prompt and complete excision along with systemic exclusion of metastases and a close follow up are necessary.
Adjuvant radiotherapy and chemotherapy could be beneficial to the patients.