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Christian K. Vorwerk, Henrike Jostmeyer, Doerthe Kuester, Wolfgang Behrens-Baumann; Mohs Micrographic Tumor Excision Of Malignant Periorbital Tumors. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4536.
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In times of increasing incidence of malignant periorbital neoplasies the demand for optimal surgical care increases as well. Especially when it comes to the very rarely metastasizing basal cell carcinoma, complete micrographic tumor excision (Mohs procedure) in three dimensions is necessary for successful therapy.
The main outcome measures for recurrence are location, prior manifestation of periorbital malignancies, defect size and histological subtype among other criteria. We retrospectively reviewed 183 cases of periorbital malignancies treated by Mohs micrographic surgery (MMS) and plastic reconstruction who presented to the Departement of Ophthalmology, University of Magdeburg between 1995 and 2005.
Of the periorbital malignancies included in the study, 31,7% were already treated in another institution at the time they presented to our clinic. Of the total 183 performed Mohs micrographic surgeries, 170 were basal cell carcinomas. The most common histological subtypes were nodular (70,6%), combined nodular and superficial (20%) and sclerodermiform (5,3%). Three patients had recurrent basal-cell carcinomas (1,64%).
Based on the literature and our own study, MMS provides the lowest recurrence rates. It is also a known, that 3D histology allows tumor excision with a minimal postoperative defect size, due to minimal loss of normal tissue. In summary, MMS is about to become the gold-standard method of treating periorbital malignancies especially in common basal cell carcinomas.
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