July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
The incidence of residual tumor and recurrence after staged excision of small periocular basal cell carcinoma
Author Affiliations & Notes
  • Saaquib Bakhsh
    Beaumont, Royal Oak , Michigan, United States
  • Jenna M Kim
    Beaumont, Royal Oak , Michigan, United States
  • Abraham Gomez
    Beaumont, Royal Oak , Michigan, United States
  • Geoffrey Gladstone
    Beaumont, Royal Oak , Michigan, United States
  • Footnotes
    Commercial Relationships   Saaquib Bakhsh, None; Jenna Kim, None; Abraham Gomez, None; Geoffrey Gladstone, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 3556. doi:
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      Saaquib Bakhsh, Jenna M Kim, Abraham Gomez, Geoffrey Gladstone; The incidence of residual tumor and recurrence after staged excision of small periocular basal cell carcinoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3556.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : In patients with biopsy-proven, small basal cell carcinoma (BCC) of the eyelid, residual BCC can be clinically difficult to identify. The authors report a cohort of patients referred to a single oculoplastic surgeon for full excision of residual BCC and reconstruction of the eyelid. We describe the rate of residual BCC and the rate of recurrence in this cohort.

Methods : We performed retrospective chart review of 38 patients between 2009 and 2014 with margin-positive BCC of the eyelid with no clinically identifiable residual BCC. After pentagonal-wedge resection of suspected areas, histopathologic studies of re-excised tissues were performed, and the incidence of histologic residua was calculated. Recurrence of BCC on follow up was recorded.

Results : Six of 38 patients (15.8%) had residual BCC on re-excision though without positive margins, while the rest had no microscopic evidence of BCC. No subjected needed further re-excision. The mean follow up was 26.8 weeks (SD 26.7). One patient in the entire cohort (1 of 38; 2.6%) developed biopsy-proven recurrence of BCC at 32 weeks. This one patient was not one of the six patients who had malignant cells at re-excision.

Conclusions : The incidence of residual malignant cells at re-excision of incompletely-excised, small BCC was 15.8% in this cohort. This is consistent with the incidence of histologically-confirmed residua in another study of periocular BCCs of various sizes. Oculoplastic surgeons tasked with re-excision of incompletely-excised, clinically-indistinct BCC should counsel patients on the low yield of the procedure but emphasize the importance of long-term follow up for recurrence even with negative margins or absence of residual malignant cells at re-excision.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


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