Eyelid Malignancies in Bangladesh: A Clinico-pathologic study Authors: Dr Syeed Mehbub Ul Kadir Dr Golam Haider Dr Murtuza Nuruddin Dr Mukti Rani Mitra BOSS Annual Conference” 2014
Eyelid Malignancies in Bangladesh:
A Clinico-pathologic study
Authors:
Dr Syeed Mehbub Ul Kadir
Dr Golam Haider
Dr Murtuza Nuruddin
Dr Mukti Rani Mitra
BOSS Annual Conference” 2014
Disclosure of the Conflict of interest
Dr Syeed Mehbub Ul KadirConsultant, Dept of Orbit & Oculoplasty Services
National Institute of Ophthalmology & Hospital
Dhaka, Bangladesh
In relation to this presentation, I declare that there are no conflicts of interest.
Introduction
Eyelid malignancies are common disorder
Basal cell Ca. (BCC), Sebaceous gland Ca (SGC) &
Squamous cell Ca are common lid cancer
It is curable if detected earlier
Management depends on size, position, type &
invasiveness of the lesion
Countries BCC SGC SqCC
Western countries 90-95% 01% 5-10%
India 44.5% 27% 14.8%
Korea 36.8% 42% 10.5%
Jeong S et al. Extensive destruction of eyeball by invasion of basal cell
carcinoma of the eyelid. Jpn J Ophthalmol. 1998; 43: 300-302
Jahagirdar SS et al. A clinicopathological study of eyelid malignancies from
central India. 2007; 55: 109-113.
Purpose
The characterize the nature, rate, associated
risk factors and management strategies of
different types of eyelid malignancies in Bangladesh
Methods
Multicentre observational case series study
2008 to 2013 (6 yrs study)
Clinically evaluated eyelid malignancies
We excluded lymphoma, conjunctival & orbital
malignancies involving the eyelid.
Methods
Excision biopsy / frozen section biopsy
Histopathology confirmed the diagnosis
Apropriate Reconstruction
Data collection : Predesigned data- sheet
with Pre & post operative photgraph
ResultsType No of Cases Percentage
Basal Cell Carcinoma 65 39.6
Sebaceous Gland Carcinoma 67 40.8
Squamous Cell Carcinoma 29 17.6
Malignant Melonoma 02 1.2
Apocrine Adonocarcinoma 01 0.6
Total 164 100
Age distribution
Types ≤ 45 yrs 46-70 yrs ≥ 71 yrs χ² value, dfP Value
BCC 12% 54% 34% 19.01
SGC 24% 66% 10%
SqCC 07% 52% 41% 08
MM 50% 50% 00
AA 00 100% 00 < 0.05
Procedure of Surgery
Excision ē 4 mm normal tissue 86 cases (52.4%)
Frozen section biopsy 72 cases (44%)
Exenteration 6 cases (3.6%)
Reconstruction No %Direct Closure 52 31
Semicircular Flap 30 19
Triangular flap 17 10
Cutler beard procedure 18 11
Hughes procedure 23 14
Mastard cheek rotational flap 05 03
Z-Plasty 03 02
Skin graft 16 10
Clinical vs Confirmatory diagnosis
Clinical Dx
BCC SGC SqCC χ²P value
BCC 63 (94%) 2 239.25
SGC 1 64 (97%) 1 < 0.001***
SqCC 1 1 26 (93%)
Recurance rate
1 case after 3 yrs of frozen section biopsy, 1.4%
5 cases ē in 2 yr of excisional biopsy, 6%
Discussion
A report from USA: BCC-90%, SqCC-
5% & SGC-4% (Holds et al.200
8)
Our study: SGC- 40.8%, BCC- 39.6%
& Sq CC-17.6%.
Age: 34 -100 yrs, > 45 yrs: 85%
Discussion
Betel leaf & nut is common risk factor
Lower Lid: 79% in BCC
Upper lid: 81% in SGC
Metastasis found in SGC
Frozen section biopsy is better option
Take home message
Sebaceous gland Ca. is highest in occurrence in BD
Frozen Section is preferred method
Early Dx & Mx may reduce the ocular morbidity