Purchase this article with an account.
Christine Vu Nguyen, Giancarlo A Garcia, Marc Yonkers, Jeremiah Tao; The Efficacy of Primary Pentagonal Wedge Resection in Achieving Negative Margins in Eyelid Basal Cell Carcinoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):698.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Typical treatment protocols for eyelid basal cell carcinoma (BCC) include two or more surgical procedures: biopsy for diagnosis followed by tumor resection with intraoperative frozen section or Mohs margin control and then defect reconstruction. Full thickness eyelid sampling obviates the deep margin concern and when gross medial and lateral margins are obtained, we hypothesize a high incidence of complete BCC (negative histologic margins) is achieved on primary resection. We evaluate the efficacy of pentagonal wedge gross tumor resection in achieving negative histopathologic margins on primary resection of small eyelid BCC.
Retrospective review of consecutive nodular eyelid BCC managed with full thickness eyelid excisional biopsy with immediate reconstruction. In all cases, the eyelid was incised in a pentagonal wedge technique with grossly visible full thickness margins around the lesion. Specimen margin status was evaluated on permanent histopathology sections. Charts were reviewed for any adverse events and subsequent related surgical interventions.
36 cases of histopathology-confirmed eyelid BCC were identified (mean age 67.3 ± 2.5 years). The majority (94.4%, p<0.001, Chi square) were completely excised with negative margins on permanent histopathology of the primary resection sample. Eyelid repair was completed immediately after excision in all cases that had short total duration. Incomplete excision with positive margins occurred in two cases (5.6%). These were managed with further tumor resection with intraoperative frozen section margin control and immediate eyelid reconstruction. Mean postoperative follow-up duration was 361 ± 109 days. In the majority of cases with complete excision there was no recurrence (97.1% p<0.001, Chi square). There was one case of recurrence (2.9%) among those with complete excision; this was the only case that required a secondary surgical procedure. There were no intraoperative or postoperative complications.
Pentagonal wedge resection of eyelid BCC was associated with a high incidence of negative primary histologic margins and definitive management in one short surgical setting. There was a low rate of recurrence at a mean of 1 year. Primary full thickness gross eyelid resection of lesions highly suspicious for BCC may obviate a need for additional procedures required with incisional biopsy techniques.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
This PDF is available to Subscribers Only