Basal Cell Carcinoma

  • Mordechai Rosner
  • Ido Didi Fabian


Basal cell carcinoma (BCC) is the most common cutaneous malignancy in the periocular area. While the mortality from BCC is low, it is capable of extensive tissue destruction, and the morbidity may be considerable. The main risk factor is ultraviolet irradiation. The most important diagnostic evaluation is histopathologic examination of the excised tissue. The main treatment modality for BCC is surgical excision of the lesion with microscopic monitoring of its margins or Mohs’ microsurgery. Long-term clinical follow-up after treatment is necessary.


Basal cell carcinoma Skin Eyelid Periocular Tumor Malignancy Ultraviolet Immune dysfunction Ionizing radiation Trauma Gorlin–Goltz syndrome Xeroderma pigmentosum Albinism Basex–Dupré syndrome Muir–Torre syndrome Rombo syndrome Linear basocellular hamartoma Sebaceous hamartoma of Jadassohn Histopathology Epidermis Basal cell Palisading Gap Surgery Mohs’ microsurgery Curettage Electrodessication Cryosurgery Radiotherapy Chemotherapy Photodynamic therapy Immunotherapy α-Interferon Imiquimod Vismodegib Hedgehog signaling pathway 


  1. 1.
    Margo CE, Waltz K. Basal cell carcinoma of the eyelid and periocular skin. Surv Ophthalmol. 1993;38:169–92.CrossRefGoogle Scholar
  2. 2.
    Yin VT, Merritt HA, Sniegowski M, et al. Eyelid and ocular surface carcinoma: diagnosis and management. Clin Dermatol. 2015;33:159–69.CrossRefGoogle Scholar
  3. 3.
    Allali J, D’Hermies F, Renard G. Basal cell carcinomas of the eyelids. Ophthalmologica. 2005;219:57–71.CrossRefGoogle Scholar
  4. 4.
    Malhotra R, Huilgol SC, Huynh NT, et al. The Australian Mohs Database, Part I: periocular basal cell carcinoma. Experience over 7 years. Ophthalmology. 2004;111:624–30.CrossRefGoogle Scholar
  5. 5.
    Paavilainen V, Tuominen J, Pukkala E, et al. Basal cell carcinoma of the eyelid in Finland during 1953–97. Acta Ophthalmol Scand. 2005;83:215–20.CrossRefGoogle Scholar
  6. 6.
    Lim VSY, Amrith S. Declining incidence of eyelid cancers in Singapore over 13 years: population-based data from 1996 to 2008. Br J Ophthalmol. 2012;96:1462–5.CrossRefGoogle Scholar
  7. 7.
    Shi Y, Jia R, Fan X. Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment. Onco Targets Ther. 2017;10:2483–9. eCollection 2017. Review.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Wade TR, Ackerman AB. The many faces of basal-cell carcinoma. J Dermatol Surg Oncol. 1978;4:23–8.CrossRefGoogle Scholar
  9. 9.
    Bakis S, Irwig L, Wood G, et al. Exfoliative cytology as a diagnostic test for basal cell carcinoma: a meta-analysis. Br J Dermatol. 2004;150:829–36.CrossRefGoogle Scholar
  10. 10.
    Leibovitch I, McNab A, Sulivan T, et al. Orbital invasion by periocular basal cell carcinoma. Ophthalmology. 2005;112:717–23.CrossRefGoogle Scholar
  11. 11.
    Allan E, Pye DA, Levine EL, et al. Non-invasive pulsed ultrasound quantification of the resolution of basal cell carcinomas after photodynamic therapy. Lasers Med Sci. 2002;17:230–7.CrossRefGoogle Scholar
  12. 12.
    Nori S, Rius-Diaz F, Cuevas J, et al. Sensitivity and specificity of reflectance-mode confocal microscopy for in vivo diagnosis of basal cell carcinoma: a multicenter study. J Am Acad Dermatol. 2004;51:923–30.CrossRefGoogle Scholar
  13. 13.
    Murra DE, Torres A, Schanbacher CF, et al. Detection of residual basal cell carcinoma by in vivo confocal microscopy. Dermatol Surg. 2005;31:538–41.CrossRefGoogle Scholar
  14. 14.
    Cook BE Jr, Bartley GB. Treatment options and future prospects for the management of eyelid malignancies: an evidence-based update. Ophthalmology. 2001;108:2088–98.CrossRefGoogle Scholar
  15. 15.
    Malhotra R, Huilgol SC, Huynh NT, et al. The Australian Mohs Database, Part II. Periocular basal cell carcinoma outcome at 5-year follow-up. Ophthalmology. 2004;111:631–6.CrossRefGoogle Scholar
  16. 16.
    Morris DS, Elzaridi E, Clarke L, et al. Periocular basal cell carcinoma: 5-year outcome following slow Mohs surgery with formalin-fixed paraffin-embedded sections and delayed closure. Br J Ophthalmol. 2009;93(4):474–6.CrossRefGoogle Scholar
  17. 17.
    Lindgren G, Larko O. Long-term follow-up of cryosurgery of basal cell carcinoma of the eyelid. J Am Acad Dermatol. 1997;36:742–6.CrossRefGoogle Scholar
  18. 18.
    Tuppurainen K. Cryotherapy for eyelid and periocular basal cell carcinomas: outcome in 166 cases over an 8-year period. Graefes Arch Clin Exp Ophthalmol. 1995;233:205–8.CrossRefGoogle Scholar
  19. 19.
    Kokoszka A, Scheinfeld N. Evidence-based review of the use of cryosurgery in treatment of basal cell carcinoma. Dermatol Surg. 2003;29:566–71.PubMedGoogle Scholar
  20. 20.
    Jaramillo-Averbe F. Cryosurgery in difficult to treat basal cell carcinoma. Int J Dermatol. 2000;39:223–9.CrossRefGoogle Scholar
  21. 21.
    Lindgren G, Larko O. Cryosurgery of eyelid basal cell carcinomas including 782 cases treated over 30 years. Acta Ophthalmol. 2014;92:787–92.CrossRefGoogle Scholar
  22. 22.
    Avril MF, Auperin A, Margulis A, et al. Basal cell carcinoma of the face: surgery or radiotherapy? Results of a randomized study. Br J Cancer. 1997;76:100–6.CrossRefGoogle Scholar
  23. 23.
    Jefford M, Kiffer JD, Somers G, et al. Metastatic cell carcinoma: rapid symptomatic response to cisplatin and paclitaxel. ANZ J Surg. 2004;74:704–5.CrossRefGoogle Scholar
  24. 24.
    Wang I, Bauer B, Andersson-Engels S, et al. Photodynamic therapy utilising topical delta-aminolevulinic acid in non-melanoma skin malignancies of the eyelid and the periocular skin. Acta Ophthalmol Scand. 1999;77:182–8.CrossRefGoogle Scholar
  25. 25.
    Ingves C, Jemec GBE. Combined imiquimod and acitretin for non-surgical treatment of basal cell carcinoma. Scand J Plast Reconstr Surg Hand Surg. 2003;37:293–5.CrossRefGoogle Scholar
  26. 26.
    Rhodes LE, de Rie M, Enström Y, et al. Photodynamic therapy using topical methyl aminolevulinate vs surgery for nodular basal cell carcinoma. Results of a multicenter randomized prospective trial. Arch Dermatol. 2004;140:17–23.PubMedGoogle Scholar
  27. 27.
    Garcia-Martin E, Gil-Arribas LM, Idoipe M, et al. Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma. Br J Ophthalmol. 2011;95:1393–6.CrossRefGoogle Scholar
  28. 28.
    Sekulic A, Migden M, Oro A, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366:2171–9.CrossRefGoogle Scholar
  29. 29.
    Curson C, Weedon D. Spontaneous regression in basal cell carcinoma. J Cutan Pathol. 1979;6:432–7.CrossRefGoogle Scholar
  30. 30.
    Edge SE, Byrd DR, Carducci MA, et al., editors. Carcinoma of the eyelid. In: AJCC cancer staging manual. 7th ed. New York: Springer; 2010.Google Scholar
  31. 31.
    Crawford C, Fernelius C, Young P, et al. Application of the AJCC 7th edition carcinoma of the eyelid staging system: a medical center pathology based, 15-year review. Clin Ophthalmol. 2011;5:1645–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mordechai Rosner
    • 1
  • Ido Didi Fabian
    • 2
  1. 1.Department of Ophthalmology, Eye Histopathology LaboratoryGoldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv UniversityTel AvivIsrael
  2. 2.Department of OphthalmologyOcular Oncology Center, Goldschleger Eye Institute, Sheba Medical Center, Sackler School of Medicine, Tel Aviv UniversityTel AvivIsrael

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