Infiltrating Basal cell carcinoma

Send This

Download

Comment

Favourite

more

Rating :

Rate It:

Embed :

Post a comment

Post Comment on Twitter Post Comment on SlideWorld

Comments:

Subscribe to follow-up comments

1 Favorites

tsetsu, favourited this 4 Years ago.

First Prev [1] Next Last

Notes

Hide Notes

Slide 1 :

Infiltrating Basal Cell Carcinoma Laura S. Gilmore, MD Department of Ophthalmology October 8, 2004 Discussant: Kenn Freedman, MD

Slide 2 :

Case Presentation CC: growth on right side of nose HPI: 81 yo HF who first noted growth on right side of nose “last December”, progressively growing. PMH: arthritis SH: ½ ppd smoker X 25 years ROS: denies F/C, significant weight loss FH: non-contributory

Slide 3 :

Physical Exam General: AAO, VSS and good VA: 20/80 OD, 20/50 OS Pupils: 3mm OU, no APD External: extensive ulcerative lesion from bridge of nose to RLL and R cheek, with almost complete destruction of RLL and nearly complete ptosis of RUL IOP, CVF, DFE normal OS, unobtainable OD

Slide 4 :

Slide 5 :

Slide 6 :

Differential Diagnosis Malignant melanoma Squamous cell carcinoma Basal cell carcinoma, infiltrative Infectious

Slide 7 :

Basics of BCC Background Most common cutaneous malignancy (~80-90%) Typically slow-growing, rarely metastasizes Sun-exposed skin, mostly face and scalp, esp nose, cheek, and periorbital regions (~80%) Frequency 900,000 Dx in US/year estimated lifetime risk of 33-39% for men and 23-28% for women Sex Men 2X over women

Slide 8 :

Basics of BCC Mortality/Morbidity <0.1% metastasize Very low mortality Significant morbidity with direct invasion of adjacent tissues, especially when on face or near an eye Age Likelihood increases with age Rare in <40 yo Race Most often in light-skinned, rare in dark-skinned races

Slide 9 :

Variants of Basal Cell Carcinoma Superficial Nodular Micronodular Infiltrating (5%) Sclerosing/ morpheaform (5%) Metatypical Infundibulocystic Nodulocystic Adenoid Clear cell Follicular Sebaceous Perineurally invasive

Slide 10 :

Perineural Invasion May be seen in 3% of pts with infiltrating and morpheaform types Most often infiltrating type, which has highest rate of local recurrence Requires CT scan for full work-up Causes? inherently aggressive behavior vs inadequate early management?

Slide 11 :

Treatment Options Electrodessication and curettage Curettage alone Surgical excision Mohs micrographically controlled surgery Cryosurgery Ionizing radiation Surgical excision plus radiation Exenteration

Slide 12 :

Factors Considered in Treatment Planning Pt preference to keep eye Pt age Surgical excision-considered definitive tx “Careful frozen section controlled excision of periocular BCCs yields cure rates comparable to Mohs micrographic surgery at 5-year follow-up” 5 year recurrence of 2.2% in one study Wong, et al. “Management of Periocular Basal Cell Carcinoma with Modified En Face Frozen Section Controlled Excision.” Ophthalmic and Plastic Reconstructive Surgery. 2002. Vol 18 (6): 430-435. Therefore, avoiding exenteration was considered a good possibility

Slide 13 :

Slide 14 :

Slide 15 :

Slide 16 :

Slide 17 :

Slide 18 :

Slide 19 :

Slide 20 :

Slide 21 :

Slide 22 :

Conclusion Basal cell carcinomas are not always as innocent as we tend to believe In formulating treatment course: Strong pt preference and other pt factors Current research

Inflammatory cell In...

Genetic mechanisms t...

T cell B cell Sir ...

Microengineering as ...

MobileASL Making Cel...

The angiogenesis in ...

Free Powerpoint Templates

	flintoff 5 Years ago.



5324 Views, 1 favourite
PowerPoint Slide Presentation on
More By User Flag as inappropriate Select your reason for flagging this presentation as inappropriate. If needed, use the feedback form to let us know more details. Cancel