Basocellular Carcinoma

Nodular basocellular carcinoma of the lower eyelid.

This kind of skin cancer, which is also called carcinoma of the basal cells, can occur in all skin-regions of the body. It is described as semi-malignant, since it damages surrounding tissue (it can infiltrate the whole eye, bones and even the orbit of the eye), but does generally not metastasize.

Risk factors are genetically disposition and UV-rays.

Basocellular carcinomas preferably occur in the face or if there is an augmented exposition to the sun.

Histological, there are different forms of the basocellular carcinoma.

These differences affect the clinical picture and the course of the disease:

• Nodular basaliom

• Superficial basaliom

• „Sclerodermiform“ basaliom; it is difficult to differ it macroscopically from healthy skin; thus it is more difficult to diagnose and to remove it

• Exulcerating basaliom; „growth like a beads“

• Pigmented basaliom

• Etc..

The most secure method to treat it, with the lowest recidivism rate, especially concerning the eyelids, is the „in sano-resection“ (in several steps and histological controlled) with a following reconstruction of the eyelid (microscopically all edges of the resected tissue have to be free of tumour).

Other methods of treatment are recommended if surgery is not adequate :

• Radiation, especially if there is a significant tumourous depth

• Kryo-therapy

• Photo-dynamic therapy : tumourous cells which are photo-sensitised are destroyed selectively by a special red light

• Local immune-therapy

Many patients who have a tumour of the eyelid have fear of a possible defacement caused by surgery.

But today specialized ophthalmologists are proficient in special reconstructive oculoplastic techniques with which they can reach an acceptable result concerning function and aesthetics.