Linear basal cell carcinoma: a distinct clinical entity in the periocular region

Abstract

Purpose: To report periocular linear basal cell carcinoma (BCC) as a distinct clinical entity, and to highlight its existence in the ophthalmic literature.

Design: Retrospective, noncomparative, multicenter, interventional small case series.

Participants: Four patients with linear BCC in the periocular region.

Intervention: All patients underwent margin-controlled excision, 3 utilizing Mohs' micrographic surgery and 1 using frozen section.

Main outcome measures: Age, gender, location, preoperative tumor size, histological growth pattern, presence of perineural invasion, number of Mohs' levels used to obtain histologic clearance, postoperative defect size, and recurrence.

Results: In all 4 cases, the site of occurrence was in the lower eyelid and cheek. Histology revealed pigmented nodular BCC with an infiltrative component in 2 cases and nodular BCC in the remaining 2 cases. No perineural invasion was noted in any of the cases. Two Mohs' levels were required for complete excision in 3 patients.

Conclusions: Linear BCC is a distinct clinical entity. Presence of the tumor along relaxing skin tension lines, increase in subclinical extension, and aggressive tumor behavior are reported observations. Because of these observations, it is suggested that margin-controlled excision should be considered for linear BCC.