Basal Cell Carcinoma of the Periocular Region

Abstract

Background: Basal cell carcinomas of the periocular area present a particular challenge because of the likelihood of damage to vital structures. Objective: More than 10-years experience of treating basal cell carcinomas by Mohs micrographic surgery was reviewed. Methods: Chart analysis of 233 periocular basal cell carcinomas was performed. All patients were contacted either in clinical follow-up or by telephone review. Results: Two hundred and thirty-three periocular basal cell carcinomas were analyzed out of a total of 3,192 basal cell carcinomas treated during this period (7.3%). Patients ranged in age from 17 to 102 years with a mean age of 58.8 years and a median of 59.0 years. Of the patients, 54.5% were female. Mohs micrographic surgery was the prime therapy in 177 patients (75.9%). Of the lesions, 48.5% occurred in the medial canthal area, 35.2% on the lower eyelid, 10.7% on the upper eyelid, and 5.6% on the lateral canthus. There was no significant difference between the left/right distribution in males and females. The average follow-up time was 34 months (standard deviation 26.38 months). A cumulative rate of no recurrence tabulated by modified life table analysis was 0.9864. Conclusion: This study further documents the problems associated with basal cell carcinoma of the periocular area as well as the value of Mohs micrographic surgery as treatment.