Mohs Micrographic Surgery for Eyelid and Periorbital Skin Cancer

Moul, Danielle K.; Chern, Peggy; Shumaker, Peter R.; Zelac, Daniel E.; Greenway, Hugh T.

doi:10.1097/iio.0b013e3181b80482

Cited by 16 publications

(16 citation statements)

References 56 publications

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“…Mohs micrographic surgery is an ideal treatment choice for eyelid SCC removal, and when performed on new lesions, the procedure is often curative . PNI arises in 4% to 14% of cases .…”

Section: Malignant Tumors Of the Eyelidmentioning

confidence: 99%

Mohs Micrographic Surgery of the Eyelid: An Overview of Anatomy, Pathophysiology, and Reconstruction Options

Harvey

Taylor

Itani

et al. 2013

Dermatologic Surgery

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Eyelid function is critical for the maintenance of ocular health and vision. MMS is an ideal skin cancer treatment for the delicate structure of the eyelid, where maximal tissue preservation is critical. There are a plethora of reconstruction options to consider after MMS has been performed in this area. The choice of repair and surgical outcome depend, in part, on the surgeon's knowledge of eyelid anatomy and his or her ability to assess the repair requirements of the post-MMS defect. Dermatologic surgeons can effectively work with other specialists to help ensure that their patients receive a cure with restored ocular function and optimal cosmesis.

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“…Mohs micrographic surgery is an ideal treatment choice for eyelid SCC removal, and when performed on new lesions, the procedure is often curative . PNI arises in 4% to 14% of cases .…”

Section: Malignant Tumors Of the Eyelidmentioning

confidence: 99%

Mohs Micrographic Surgery of the Eyelid: An Overview of Anatomy, Pathophysiology, and Reconstruction Options

Harvey

Taylor

Itani

et al. 2013

Dermatologic Surgery

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“…En la región periocular, el carcinoma escamocelular ocupa el segundo lugar en frecuencia y corresponde a 5 a 10 % de los tumores periorbitarios; le siguen el melanoma, el carcinoma sebáceo y el carcinoma microquístico de los anexos, los cuales son relativamente infrecuentes. Al igual que el carcinoma basocelular, el escamocelular es más frecuente en el párpado inferior que en el superior, con una razón de 4 a 1, y ocupa el tercer lugar en frecuencia en el canto interno 3,4,20 .…”

Section: Carcinoma Escamocelularunclassified

“…Existen controversias en cuanto a las modalidades terapéuticas para la resección del melanoma, debido a la dificultad para diferenciar las células melanóticas malignas de los melanocitos atípicos, los cuales se localizan en el margen del tumor y pueden ser secundarios a daño solar 3,4 . Sin embargo, la información disponible favorece la cirugía micrográfica de Mohs para el tratamiento del melanoma in situ o de poca profundidad (menos de 1 mm), en la región periorbitaria.…”

Section: Melanomaunclassified

“…El cáncer de piel localizado en la región periorbitaria es infrecuente 1,2 . Se ha estimado que, aproximadamente, 5 a 10 % de todos los cánceres de piel se ubican en la región periorbitaria, con mayor frecuencia en mayores de 60 años y con una relación entre hombres y mujeres de 3 a 1 3,4 . El párpado y, en general, la región periorbitaria son sitios anatómicos asociados a un gran riesgo de recurrencia y metástasis.…”

Section: Introductionunclassified

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Tratamiento quirúrgico y reconstrucción del cáncer periorbitario

Olmos¹,

Portilla²,

Castro³

2013

rev. asoc. colomb. dermatol. cir. dematol.

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Introducción. Se ha estimado que, aproximadamente, 5 a 10 % de todos los cánceres de piel se ubican en la región periorbitaria. El párpado y, en general, la región periorbitaria son sitios anatómicos asociados a un gran riesgo de recurrencia y metástasis. Las recomendaciones sugieren practicar cirugía micrográfica de Mohs y escisión de segmentos por congelamiento.Objetivo. Describir los antecedentes y el contexto actual del tratamiento quirúrgico y la reconstrucción para cáncer periorbital.Métodos. Se hizo una búsqueda en la literatura científica, utilizando las palabras clave (MeSH): neoplasms, carcinoma, squamous cell, basosquamous, melanoma, Mohs surgery, y operadores booleanos. Las bases de datos donde se hizo la búsqueda fueron: Pubmed, Ebsco Host, Embase, Lilacs, Science direct y Ovid.Conclusiones. La cirugía micrográfica de Mohs es actualmente la opción terapéutica y diagnóstica más completa y con menores tasas de recidiva para el tratamiento quirúrgico de tumores cutáneos complejos; además, permite ahorrar tejido sano con la seguridad de la erradicación tumoral. Se sugiere realizar estudios analíticos para establecer una mejor evidencia.

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“…A técnica foi desenvolvida por Frederic E. Mohs nos anos 1940 e consiste em remover tumores de pele em camadas sucessivas que são avaliadas microscopicamente. As margens periféricas e profundas são totalmente avaliadas, criando um mapa da presença do tumor e guiando a exerese (26) (Figura 1). (26) Entretanto, a maioria dos cirurgiões prefere realizar a excisão da lesão com margens clinicamente livres (2 a 4 mm), fazendo seu controle histológico com congelação ou através do resultado anatomopatológico final, pois alguns trabalhos sugerem taxas de cura similares à técnica de Mohs (27)(28)(29)(30) .…”

Section: Descriptorsunclassified

Avaliação da eficácia e segurança da imunoterapia tópica com imiquimode creme 5% no tratamento do carcinoma basocelular nodular periocular

Macedo¹

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Clinical Trials.gov Identifier: NCT00803907 Apoio do CNPq-processo n° 480144/2008-7 ARTIGO ORIGINAL Recebido para publicação em 2/11/2011-Aceito para publicação em 2/3/2011 ABSTRACT Purpose: The objective of this study was to compare the estimated cost of clinical and surgical treatment for basl cell carcinoma of the eyelid. Methods: This was a pilot study of 12 patients with basal cell carcinoma receiving treatment with 5% imiquimod cream at the ocular plastic surgery center, medical school University of São Paulo (HC-FMUSP, Brazil). The cost of clinical treatment was estimated based on the time of treatment and amount of medication consumed by patients in the home setting. The cost of surgical treatment was estimated by ophthalmologists with experience in reconstructive plastic surgery based on analysis of images of the same patients. Surgeons responded to a questionnaire with four questions about surgical technique, surgical materials required, estimated duration of surgery and type of anesthesia.Results: Immunotherapy lasted from 8 to 12 weeks. All patients reported each cold-stored sachet with 5% imiquimod cream lasted 3 days. According to the institution, a box with 12 sachets costs BRL 480.00. Patients required 1.58-3.11 boxes for complete treatment, corresponding to a total cost of BRL 758.40-1,492.80. Based on image analysis, surgeons evaluated surgery would require 1-3 hours. The estimated cost of surgery room and staff was BRL 263.00, to which the cost of supplies was added. Thus, the total cost of surgical treatment was BRL 272.61-864.82. On the average, immunotherapy was 57,64% more costly than surgical treatment. Conclusions: Malignant eyelid tumors are a common finding in clinical ophthalmology. Surgery is still the treatment of choice at our institution, but immunotherapy with 5% imiquimod cream may be indicated for patients with multiple lesions or high surgical risk and for patients declining surgery for reasons of fear or esthetic concerns. The ability to estimate costs related to the treatment of malignant eyelid tumors is an important aid in the financial planning of health care institutions. Further studies should evaluate the possibility of institutions equating the cost of immunotherapy and surgical treatment by acquiring similar but less expensive medications.

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Mohs Micrographic Surgery for Eyelid and Periorbital Skin Cancer

Cited by 16 publications

References 56 publications

Mohs Micrographic Surgery of the Eyelid: An Overview of Anatomy, Pathophysiology, and Reconstruction Options

Mohs Micrographic Surgery of the Eyelid: An Overview of Anatomy, Pathophysiology, and Reconstruction Options

Tratamiento quirúrgico y reconstrucción del cáncer periorbitario

Avaliação da eficácia e segurança da imunoterapia tópica com imiquimode creme 5% no tratamento do carcinoma basocelular nodular periocular

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