RECURRENT PERIOCULAR BASAL CELL CARCINOMA. CASE REPORT.

Abstract

AIM\nWe present the management of a\xa0severe case of recurrent periocular basal cell carcinoma, orbital invasion and exenteration.\n\n\nCASE REPORT\nThe present case is of a\xa0recurrent basal cell carcinoma in a\xa084-year-old male presenting with non-healing lesion above right eyelid. A\xa0tumor excision was performed in May 2014. Histopathology revealed a\xa0basal cell carcinoma (dg. C44.1 ICD-10-CM) with positive margins. The re-excision of the lesion was performed. After two years, there was a\xa0local recurrence and orbital invasion. Indication for external curative radiation therapy. Plastic surgery of the upper eyelid. Orbital exenteration was indicated in January 2018. After another year, a\xa0recurrence of the tumor was once again noted. Histopathology revealed a\xa0basal cell carcinoma (dg. C44.1 (TNM 7, pMx, pNx, pTx)). The patient was indicated for external radiotherapy. There were no indications for biological treatment. After another year, a\xa0progression of the local finding was noted.\n\n\nCONCLUSION\nBasal cell carcinoma (BCC) is the most common non-melanoma skin cancer of the periocular region. Primary treatment of basal cell carcinoma is surgical. Advanced lesions require extensive surgical interventions and other available treatment modalities. In some cases, mutilating surgery - exenteration of the orbit is inevitable. Despite a\xa0relatively small percentage of invasive diseases today, advanced stages may still occur; either as a\xa0result of the patient s\xa0late presentation, inadequate initial therapy aimed at maintaining critical periorbital structures, or due to high tumor aggression. The case report highlights necessity of radical resection of primary tumor with histological examination.