Basal cell carcinoma of the eyelids and periorbital region in a Turkish population.
OBJECTIVE
To review the clinical and histopathologic features, treatment, and outcomes of eyelid basal cell carcinomas.


METHODS
The clinical records and histopathologic specimens of 311 patients with eyelid basal cell carcinomas were reviewed and analyzed retrospectively. The main outcome measures are patient demographics, clinical characteristics, lesion size, duration of lesion, histologic subtypes, presence of orbital and perineural invasion, severity of peritumorous inflammation, treatment modalities, recurrence rate, tumor-related death, and prognostic features.


RESULTS
Two-hundred ninety patients underwent surgery whereas others received radiotherapy or chemotherapy. The most common histologic subtypes were infiltrative, nodular, and basosquamous basal cell carcinomas. Nearly one-third (29.9%) of the patients were previously recurrent. Orbital and perineural invasion rates were 17.04% and 10.6%, respectively. Recurrent basal cell carcinomas were larger, with longer duration of lesion and a higher rate of orbital and perineural invasion. Basosquamous basal cell carcinomas were more likely to have prior recurrences, larger lesion size, and the highest rate of orbital invasion. Perineural invasion was most frequent in morpheaform and basosquamous subtypes. Peritumorous inflammation differed between subtypes and was highest in the superficial subtype. The recurrence rate was 7.39% in total. The death of 2 patients was tumor-related.


CONCLUSIONS
In this large case series from a single center, the outcomes were worse than previously reported due to delay in treatment and previous inadequate treatments. Adverse prognostic factors associated with secondary orbital invasion are previous recurrences, aggressive histologic subtypes, longer duration of lesion, larger lesion size, and the presence of perineural invasion.
Department of Ophthalmology, Ankara Oncology Education and Research Hospital, Ankara, Turkey. hulya@pleksus.com.tr
Hülya Gökmen
HG
Soysal
Ergin
E
Soysal
Fatma
F
Markoç
Fisun
F
Ardiç
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005142:Eyelid Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009918:Orbital Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology