Outcome of Periocular Basal Cell Carcinoma Managed by Overnight Paraffin Section

Abstract

For primary BCCs the recurrence rate in this study was low and comparable to that following Mohs' technique. This approach, using routine pathological facilities, therefore offers a viable technique for managing periocular BCCs.

Surgical treatment of periocular basal cell carcinomas - 15 years of experience

“…In their study Khandwala et al achieved 56.9% histological clearance after the initial operation with 3 mm margins, after re-excision they found tumor cells in 14.3% (5/35) (13). In our study the excision line was 3 mm from the tumor edge and we achieved 62.2% complete primary excision.…”

“…Ghauri et al found that 5% of tumors reported as having clear margins on frozen section were seen later to have involved margins on permanent section (8). Khandwala et al, reported the results of using a standard paraffin section technique to confirm histological clearance and found low recurrence rate (1.7%), which is comparable to that following Mohs' technique (13). The principle risk factors for recurrence include previous treatment, localization, large tumor size and an infiltrative or micronodular histological growth pattern (1,18,25).…”

“…BCCs are the most common periocular skin cancers, accounting for 80-90% from all cases (13,18). There are reports suggesting the increasing incidence of BCC located on the eyelids over the last decades (20).…”

“…Periocular skin tumors are the most common tumors encountered in clinical ophthalmic practice (13,14,16). BCCs are the most common periocular skin cancers, accounting for 80-90% from all cases (13,18).…”

Management of skin cancers without margin control: can it really be an acceptable practice?

“…Mohs micrographic surgery is considered the gold standard, as it is shown to achieve a 98% 5-year cure rate (1773 cases of basal cell carcinoma) 3. Modifications have been sought because of the stringent training and processing requirements of the original technique, and acceptable results have been achieved with staged Slow Mohs4 and multistage fast paraffin sections,5 with maybe a varying of the margins based on tumour morphology 6…”