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Surgical treatment of periocular basal cell carcinomas - 15 years of experience

Zornitsa Zlatarova, Binna Nenkova, Christina Grupcheva


PURPOSE: To analyze the outcome of periocular basal cell carcinoma (BCC) treated by surgical excision and evaluated using formalin fixed, paraffin-embedded sections.

METHODS: One hundred-ninety-three patients with periocular BCC, were operated in Department of ophthalmology and Specialized Eye Hospital, Varna, Bulgaria since 1999 to 2013. Data were analyzed considering demographics, tumor localization, histological results, type of eyelid reconstruction, recurrence rate and aesthetic outcome.

RESULTS: Of the total 193 patients with BCC, 136 (70.5%) had lower eyelid involvement. The most common histologic subtype was solid 126 (65.3%). One hundred seventy-six patients (91.2%) were with primary and 17 (8.8%) with recurrent tumors. Fifty-nine percent of lid defects were treated by direct closure. The mean follow-up period was 50 months. There were 15 (7.8%) recurrences. Excellent aesthetic outcome was achieved in 45%.

CONCLUSIONS: Basal cell carcinoma is the most common malignant tumor of the eyelid engaging mainly the lower eyelid. Surgical excision with paraffin sections is a viable technique for managing periocular BCCs. Delayed repair is advisable in cases of poorly demarcated tumors. Significantly higher risk of recurrence exists in a more aggressive form of BCC. Using different techniques of reconstruction provides very good functional and aesthetic results.


basal cell carcinoma; eyelid; surgical excision; recurrence rate

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About The Authors

Zornitsa Zlatarova
Medical University of Varna

Department of Ophthalmology and Visual Science

Binna Nenkova
Medical University of Varna

Department of Ophthalmology and Visual Science

Christina Grupcheva
Medical University of Varna

Department of Ophthalmology and Visual Science

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