gms | German Medical Science

To analyse efficiency of small margin excision of periocular non-infiltrative basal cell carcinoma (BCC).

Documentation of all 69 patients with histologically proven BCC of the eyelids referred to our department during years 1998 and 2005 was analysed. The retrospective study engaged 53 patients with non-infiltrative periocular BCC, that were controlled in our department until year 2006. Primary treatment was non-Mohs' surgical excision of the tumor with 2-mm safety margin without intraoperative frozen section control (IFS). Patient age, gender and tumor location were recorded. We were interested in frequency and location of histologically incompletely excised BCCs and specially in tumor recurrence rate.

Of 53 patients there were 29 female (55%) and 24 male (45%). Mean follow-up was 31.7±24.9 months. Mean age of patients was 69±12 years. Most BCC grew up on lower eyelid (66%), some in medial canthal area (21%) and least on upper eyelid (7%) and in lateral canthal area (6%). Only 23% of them invaded margin of the eyelid. Four of referred tumors (8%) were recurrences. 85% of eyelid defects were treated by primary direct closure, 11% with primary ear skin-cartilage graft and 4% with full thickness skin grafts. 43 tumors (81%) were histologically completely and 10 tumors (19%) incompletely excised, 3 of theme were already recurrences. Complete removal of primary non-infiltrative BCC was therefore achived in 86%. Majority of incompletely excised tumors was in medial canthal area (6 of 11; 55%) and few on the lower eyelid (4 of 35; 11%). The overall recurrence rate with mean 2,5-year follow-up was 6%, representing 2 recurrences after incomplete (2 of 10; 20%) and 1 after complete excision (1 of 43; 2%).

Small margin excision of non-infiltrative primary periocular BCC without IFS control is safe and efficient treatment with maximal preservation of healthy tissue.