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ME Hartstein, JB Holds, I Fedorovich; Invasive Basal Cell Carcinoma (BCCA) to the Orbit: Clinical Characteristics and Outcome . Invest. Ophthalmol. Vis. Sci. 2002;43(13):3038.
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Purpose: To report clinical characteristics in cases of orbital invasion by BCCA seen at our institution over 10 years. (1990-2001). Methods: Records of 20 (13 female and 7 male) patients presenting with orbital invasion of BCCA over a 10-year period were reviewed, including history, initial examination, surgical and medical management and follow up. Results: Patients ranged from 49 to 90 years of age. Eight of the patients first presented to the physicians with orbital invasion of BCCA, and twelve presented with recurrent disease 2 to 15 years after incomplete excision. Nine patients underwent orbital exenteration; seven after at least one previous attempt at local resection (3 patients received postoperative radiation). Six patients underwent total tumor excision with reconstruction; one, refusing exenteration, underwent subtotal resection of the tumor. Three patients refused any treatment; one did not undergo surgery due to medical problems. Follow up period ranged from 1 month to 4 years. Conclusion: Denial of the disease process with delayed presentation is common in patients with orbital invasion of BCCA. Early presentation in the course of the disease and primary lesions were more readily curable, and more frequently amenable to avoid orbital exenteration. Advanced disease requires aggressive treatment to achieve cure. Exenteration cured all but most advanced cases of orbital invasion of BCCA.
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