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Answers: 2009 Series -  March 17, 2009 Lecture 42 of 52  NEXT»

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Photos courtesy of: Prof. Dinesh Selva, Adelaide, Australia
Used with permission. Not to be reproduced.

A 65-year-old man presented with some irritation in the left eye for the past few months. The clinical picture is as shown above. Slit lamp biomicroscopy reveals normal anterior and posterior segment in both eyes.

1. What is the clinical diagnosis?

c -- basal cell carcinoma

A fair-skinned patient, clinical features of a nodule lesion with ulceration at one edge, fine telengiectasias, and loss of eyelashes are suggestive of basal cell carcinoma.

Sebaceous gland carcinoma occurs more in the Oriental population.  It involves upper lids more commonly due to the larger number of meibomian glands in the upper eyelid.  Examination of conjunctival surface in sebaceous gland tumors may show yellowish-white secretions of the affected gland and eyelash loss.

2. The treatment options would be:

a -- excision biopsy with wide margins

All such lesions should be excised with nearly 4 mm margin, beyond the clinically evident margin of lid tumor.  Intraoperative frozen section would be ideal to rule out any involved margin in the excised specimen.

Lid reconstruction in such cases should be planned in such a way that early recurrences can be picked up easily under flaps or grafts.


Lecture 42 of 52 «Previous Lecture   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52    Next»