Background. Basal cell carcinoma (BCC) is the most common malignancy of the eyelids. Medial canthal BCCs tends to recur more often. Purpose. To evaluate the clinical and histological features of primary and recurrent periocular BCC, in order to identify any existing associations. Methods. Data from 87 patients (71 primary and 16 recurrent) were analyzed in this study. All patients underwent tumor excision with frozen section margin control at the Goldschleger Eye Institute between 1/1995 to 12/1997. Statistical analysis was performed to identify possible associations between histological and clinical characteristics of primary and recurrent BCC. Main Outcome Measures. Anatomical location, clinical presentation, and histology of peri-ocular BCC. Results. No association was found between histopathological and clinical characteristics of BCC. Similar features with regard to eyelid location and histology were found in primary and recurrent peri-ocular BCCs, whereas recurrent BCCs tended to involve a greater eyelid extent with a longer duration of symptoms. Medial canthal BCCs, morpheaform, or sclerosing histology were not more common in the recurrent BCC group. Conclusions. Similar clinical and histological characteristics were noted in primary and recurrent periocular BCC, implying that incomplete surgical excision rather than anatomical location or histological features is the main cause for recurrence. 1. Introduction Basal cell carcinoma (BCC) is the most common skin cancer and accounts for 80–95% of all eyelid tumors. Prolonged exposure to sunlight seems to be an important predisposing factor [1], explaining why the tumor occurs more frequently on the lower eyelid [2]. BCC originates as a neoplastic transformation of the basal cells of the epidermis that proliferate and invade into the dermis as bulbous nodules or invasive strands. Classification can be made according to its clinical features, histological differentiation, or growth patterns. While several clinical types have been noted, there are multiple histopathological differentiations of BCC [3, 4]. BCC generally exhibits slow growth. The tumor may invade the adjacent tissues and cause their destruction but it rarely metastasizes [2, 5]. The goal of treatment is to completely excise the BCC in order to prevent recurrence. While several treatment modalities have been described, complete excision with margin control either by frozen sections or Mohs’ micrographic surgery (MMS) remains the gold standard and assures low recurrence rate, with incomplete excision being the main cause for recurrence
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