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Surgery Neoplasia 5d96ace8

Most common tumor of eyelid is

A
Basal cell carcinoma
B
Keratoacanthoma
C
Melanoma
D
Squamous cell carcinoma
High-Yield Explanation
Ans. a (Basal cell carcinoma). (Ref. Baily & Love, 25th/pg. 609)BASAL CELL CARCINOMA (BCC, rodent ulcer)# Basal cell carcinoma is the commonest form of skin cancer and typically affects individuals between the ages of 40 and 79 years; 50 percent are male.85 percent occur in the head and neck region.# Are thought to originate from pluripoten epithelial cells of the epidermis and hair follicles.# BCCs grow slowly, but locally invasive and penetrate deeper tissues -- hence the term rodent ulcer,# Metastasis is rare.# Typically these tumours have a nodular appearance with a pearly rolled edge (which is apparent on stretching the skin) and telangiectatic vessels.# Clinically types in order of frequency:- Nodular: 50-54%; (90% nodular/nodular cystic). Superficial : 9-11%;- Cystic: 4-8%; Pigmented: 6%; Morpheic : 2%.# Treatment:- Surgical excision -- the treatment of choice with cure rates between 85 and 95%.- Electrodessication and curettage -- commonly used for small superficial lesions (2--5 mm in diameter) gives cure rates between 85 and 100%.- Radiotherapy -- BCC is very radiosensitive and has an overall response of 92 % in selected patients. This is reserved for elderly patients who are not suitable for surgery or for specialised anatomical sites.- Moh's micrographic surgery (chemosurgery) --involving serial horizontal excision and mapping of the tumour. Usually reserved for recurrent lesions, tumours in difficult areas or those with indistinct borders (morphea-form).- Following complete excision it is unnecessary routinely to follow-up these patients unless they have a familial disposition for BCC formation (Gorlin's syndrome).

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