PubMed · 3718306
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R L Anderson. 1986. Mohs' micrographic technique.. https://doi.org/10.1001/archopht.1986.01050180052029
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BACKGROUND: Chronic, non- or little pigmented reddish or brownish lesions on the lid margin and the surrounding skin are frequently underestimated and thus carry a clear risk of malignancy. HISTORY AND SIGNS: A 61-year-old lady was referred with a chronic, reddish lesion in the medial third of the left lower lid after a topical therapy over a period of 4 months had not improved the situation. She noticed the lesion for the first time 10 previously. Recurrent trichiasis and a slight ulceration had developed during the last year. THERAPY AND OUTCOME: After an unclear result of the biopsy (2)/ (3) of the left lower lid were removed because of atypical cells ascending into the epidermis. A superficial spreading melanoma 0.4 mm depth in the Breslow classification was detected and right next to it a superficial basal cell carcinoma. The lid defect was reconstructed with a tarsoconjunctival flap and a free full thickness skin graft as described by Hughes. CONCLUSION: Chronic redness at or around the lid margin which does not respond to therapy should be biopsied as malignant tumours may well be hidden behind it.
PURPOSE OF REVIEW: The management of benign and malignant eyelid neoplasms has been extensively examined. This paper offers an overview of the most common eyelid lesions and their management based on a review of the relevant bibliography. RECENT FINDINGS: Recent studies have focused on the results of nonsurgical approaches for benign and premalignant lesions that are routinely surgically excised. In the malignant group, a consensus has been reached over the preferred method of tumor excision for basal cell carcinoma: Mohs surgery or complete surgical excision with frozen-section control of the margins offers the lowest tumor-recurrence rate. Important acquisitions have been made on squamous cells for which sentinel node biopsy may reveal early metastatic cancer. Intraepithelial tumor growth is a peculiar feature of sebaceous gland carcinoma that seems to indicate an increased risk for orbital invasion. Recent reports regarding the rare tumor, Merkel cell carcinoma, recommend a wide surgical excision with 5 mm margins; this may reduce the incidence of lymph-node metastasis, haematogenous spread and local recurrences. SUMMARY: Although treatment of the most common benign and malignant tumours affecting the eyelids has not radically changed over the years, recent reports have significantly improved the standard of care for affected patients.