The Method of En Face Frozen Section in Clearing Periocular Basal Cell Carcinoma and Squamous Cell Carcinoma

Kvannli, Line; Benger, Ross; Gal, Andrew; Swamy, Brighu

doi:10.3109/01676830.2012.679170

Cited by 8 publications

(7 citation statements)

References 10 publications

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“…Several optional treatments have been suggested for periorbital BCC such as chemotherapy [ 7 , 8 ], traditional surgical excision [ 9 – 11 ], photodynamic therapy [ 12 , 13 ], Mohs micrographic surgery [ 14 – 16 ], and laser ablation [ 17 – 20 ].…”

Section: Introductionmentioning

confidence: 99%

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

Ebrahimi

Rezaei

Kavoussi

et al. 2014

Dermatology Research and Practice

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Background. Periorbital basal cell carcinoma (BCC) is considered a high risk case because it is associated with high rate of recurrence and complication. Superpulsed CO2 laser with intraoperative pathologic assessment could be an alternative and appropriate treatment for periocular lesions where Mohs micrographic surgery is not available. Objective. To evaluate the efficacy of superpulsed CO2 laser therapy with intraoperative pathologic assessment on periocular BCC involving eyelash line. Method. This follow-up study was performed on 20 patients with a total of 21 BCC lesions that were pathologically documented. Firstly, debulkation of tumoral mass was done by curettage. Then, irradiation and intraoperative pathologic evaluation were done by concurrent CO2 laser. The patients were followed up for a period of 36 months. Results. Out of 21 lesions, the nodular type accounted for 15 (71.4%) lesions, and 12 (57.1%) lesions were seen in the lower lid as the most common clinical type and site involvement. Twenty BCC lesions (95.2%) were treated after one session. Damage to eyelash was seen in 2 (10%) patients, but ectropion and other complications were not seen in any patient. Conclusion. Treatment with superpulsed CO2 laser and intraoperative pathologic evaluation for periorbital BCC lesions much close to conjunctiva could be an effective method with minimal complications without major danger of recurrence. This modality can be used with care in the inner canthus and high risk pathologic lesions.

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Section: Introductionmentioning

confidence: 99%

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

Ebrahimi

Rezaei

Kavoussi

et al. 2014

Dermatology Research and Practice

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“…MMS is said to be the "gold method" at some institutions (13,14) that previous studies showed that excision of BCC with pathological evaluation of the margins, i.e. MMS and en face FS, have the lowest relapse rates and best tissue conservation rate (14). Our results demonstrate high diagnostic accuracy, but very low sensitivity and kappa coefficient for margin evaluation with TST.…”

Section: Discussionmentioning

confidence: 54%

“…The treatment option for BCC consists of Mohs' micrographic-controlled or en face frozen section controlled surgical excision with later routine pathology sections, cryotherapy, radiotherapy and medical treatment (12). MMS is said to be the "gold method" at some institutions (13,14) that previous studies showed that excision of BCC with pathological evaluation of the margins, i.e. MMS and en face FS, have the lowest relapse rates and best tissue conservation rate (14).…”

Section: Discussionmentioning

confidence: 99%

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

et al. 2017

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Background: Mohs' micrographic surgery is a suitable treatment and frozen section (FS) examination is the "gold standard" of surgical margins in tumoral skins. This study compared the diagnostic accuracy between the Tzanck smear test (TST) and frozen section (FS) examination for margin control in surgery for basal cell carcinoma (BCC). Methods: Fifty-nine patients with basal cell carcinoma (BCC) were included. The tumor was excised and the Tzanck smear test (TST) was taken for Papanicolaou staining (Pap staining) and reconfirmation of tumoral cells. Then a dermatologist took margins of tumoral mass. TST was taken from the margins and sent to the dermatopathologist for Pap staining. After dying, each marked fragment was sectioned separately with cryostat. Finally, diagnostic accuracy of TST compared with FS examination was analyzed. Results: The sensitivity and specificity of TST for the evaluation of margin were 0.28 and 0.95; whereas positive and negative predictive values were 0.54 and 0.85, respectively. Positive and negative likelihood values were 5.36 and 0.76, respectively. Diagnostic accuracy was 0.82. The kappa coefficient of agreement between the two methods was 0.28 (P < 0.001). Conclusions: Positive likelihood value and specificity of TST for the evaluation of margin were high; therefore, TST can be suitable in the diagnosis of BCC, but due to low sensitivity and kappa coefficient, TST alone cannot be a suitable alternative method compared to the FS examination for margin control in BCC.

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“…98 One hundred twenty BCCs had a full-thickness eyelid ''wedge'' resection, of which 45% needed more than the standard 2 frozen sections taken to achieve clear margins. Krema and associates 99 found 94% cure rate in a series of 90 such patients. On the contrary, the suboptimal nature of the initial resections underlines the inadequacy of clinical judgment and the critical role of histological control.…”

Section: Sweat Gland Tumorsmentioning

confidence: 90%

“…98 Kvannli and associates 99 looked at the percentage of cases of BCC in which further resections were needed beyond the boundaries of the initial excision for complete tumor clearance, using the en face frozen section technique. 98 Kvannli and associates 99 looked at the percentage of cases of BCC in which further resections were needed beyond the boundaries of the initial excision for complete tumor clearance, using the en face frozen section technique.…”

Section: Sweat Gland Tumorsmentioning

confidence: 99%

Recent Advances in Ophthalmic Plastic Surgery

Honavar¹,

Manjandavida²

2013

Asia-Pacific Journal of Ophthalmology

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The Method of En Face Frozen Section in Clearing Periocular Basal Cell Carcinoma and Squamous Cell Carcinoma

Cited by 8 publications

References 10 publications

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

Recent Advances in Ophthalmic Plastic Surgery

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The Method of En Face Frozen Section in Clearing Periocular Basal Cell Carcinoma and Squamous Cell Carcinoma

Cited by 8 publications

References 10 publications

Superpulsed CO2Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

Superpulsed CO2Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

A Diagnostic Accuracy Comparison Between Tzanck Smear Test and Frozen Section Examination in Basal Cell Carcinoma

Recent Advances in Ophthalmic Plastic Surgery

Contact Info

Product

Resources

About

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line

Superpulsed CO₂Laser with Intraoperative Pathologic Assessment for Treatment of Periorbital Basal Cell Carcinoma Involving Eyelash Line