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S. Patel, C. Rosenberg, R. Lisman; Efficacy of Deep Tissue Frozen Sections in Guidance of Excision of Eyelid Carcinomas. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5745.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the yield of deep tissue margins in surgical excisions of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) with frozen sectioningBackground: Surgical excision of periocular skin cancer with histiologic sectioning of tissue margins allows decreased tumor recurrence. However tissue processing tends to increase surgical time with large margins removing healthy tissue, making for more difficult repairs.
A retrospective study between 1/2005 and 12/2007 of all consecutive patients who had excision of periocular cancer by a single surgeon was performed. All patients had surgical excision of the tumor with a minimum 2-mm margin. Frozen sections were performed by two ocular pathologists and reconstruction performed if histological clearance was confirmed. If tumor was still present, a further margin was excised before reconstruction.
This study yielded 35 primary BCCs and 2 primary SCCs. The tumor characteristics were as follows: 11% had a maximum surface measurement less than or equal to 10 mm2, 41% had a surface area of 10-50 mm2, 48% were greater than 50 mm2. 89% were localized to the lower lid with 43% located medially, 13.5% involving the canaliculus. 8 (22%) cases returned positive margins, requiring further excision based on the initial histological reports, tumor was seen in only 2 (5%) cases. Positive margins were unrelated to size of tumor, age, or sex, but was weakly correlated with medial location (P=0.07). Deep tissue margins were taken in all cases yielding no positive sections; however, non-cancerous basaloid cells were seen in a single deep tissue margin. There were no recurrences.
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