title: Advanced Basal cell carcinoma in a patient with schizoaffective disorder: constraints and management.
abstract: The approach used by the authors for managing a patient with a schizoaffective disorder and advanced basal cell carcinoma involving the eyelids, orbit, and face is presented. Complexities included the advanced nature of the disease, neglect of the patient's condition due to schizoaffective disorder, the difficulty of obtaining informed consent, the required aggressive surgical intervention, reconstruction, and the necessary management during the postsurgical period. A multidisciplinary team approach with psychiatry, ophthalmology, ear, nose, and throat, plastic surgery, radiation oncology, oncology, legal, and bioethics specialties is required in patients with cognitive disabilities. Curative treatment requires complete excision, reconstruction, and proper postoperative care, which can be prohibitive in a schizophrenic patient from a surgical and ethical perspective. Staging of this condition after proper informed consent with biopsy, computed tomography, and magnetic resonance imaging is presented. The options for management are discussed, including surgical intervention and palliative care.
authors.affiliation: Martel Eye Medical Group, Rancho Cordova, California, USA.
authors.forename: Elise J
authors.initials: EJ
authors.lastname: Taylor
authors.forename: Liliya
authors.initials: L
authors.lastname: Golas
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Martel
authors.forename: James B
authors.initials: JB
authors.lastname: Martel
mesh_terms: D001675:Bioethics; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000601:surgery; D005142:Eyelid Neoplasms / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007258:Informed Consent; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009367:Neoplasm Staging; D013508:Ophthalmologic Surgical Procedures; D010348:Patient Care Team; D011618:Psychotic Disorders / Q000150:complications*; D019651:Plastic Surgery Procedures; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed