title: Management of periorbital basal cell carcinoma with orbital invasion.
abstract: Basal cell carcinoma (BCC) is the most common eyelid malignancy; however, orbital invasion by periocular BCC is rare, and management remains challenging. Established risk factors for orbital invasion by BCC include male gender, advanced age, medial canthal location, previous recurrences, large tumor size, aggressive histologic subtype and perineural invasion. Management requires a multidisciplinary approach with orbital exenteration remaining the treatment of choice. Globe-sparing treatment may be appropriate in selected patients and radiotherapy and chemotherapy are often used as adjuvant therapies for advanced or inoperable cases, although the evidence remains limited. We aim to summarize the presentation and treatment of BCC with orbital invasion to better guide the management of this complex condition.
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital & University of Adelaide, Adelaide, South Australia 5000, Australia.
authors.forename: Michelle T
authors.initials: MT
authors.lastname: Sun
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital & University of Adelaide, Adelaide, South Australia 5000, Australia.
authors.forename: Albert
authors.initials: A
authors.lastname: Wu
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital & University of Adelaide, Adelaide, South Australia 5000, Australia.
authors.forename: Edwin
authors.initials: E
authors.lastname: Figueira
authors.affiliation: Department of Dermatology, Royal Adelaide Hospital & University of Adelaide, Adelaide, South Australia 5000, Australia.
authors.forename: Shyamala
authors.initials: S
authors.lastname: Huilgol
authors.affiliation: South Australian Institute of Ophthalmology, Royal Adelaide Hospital & University of Adelaide, Adelaide, South Australia 5000, Australia.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D019468:Disease Management; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: basal cell carcinoma; basosquamous basal cell carcinoma; cisplatin-based chemotherapy; exenteration; fixed mass; globe displacement; globe-sparing excision; infiltrative basal cell carcinoma; limited ocular motility; medial canthus; morpheoform/sclerosing basal cell carcinoma; perineural invasion; periocular; radiation therapy; recurrent tumor; vismodegib