Histological subtypes of periocular basal cell carcinoma

Abstract

Background: To determine the proportion of different subtypes of periocular BCC in South Australia. Design: Retrospective review. Participants: One thousand seven hundred thirteen consecutive periocular basal cell carcinoma (BCC) excision specimens. Methods: Histological analysis of consecutive periocular BCC specimens. Main Outcome Measures: Date of resection, patient age at resection, gender, tumour location, histological subtype and perineural invasion. Results: From 2006 to 2012, a total of 1713 consecutive periocular BCC excision specimens were analysed. The mean age at resection was 68.8 years (median: 71, range: 21–101). Most specimens (56.4%) were removed from male patients. 52.7% involved the lower eyelid, 29.0% the medial canthus, 10.9% the lateral canthus and 7.5% the upper eyelid. The main histological subtypes identified were nodular (65.7%), infiltrative (17.5%), superficial (12.6%) and micronodular (4.2%). Of the specimens, 25.6% had more than one subtype. The most common subtype combinations were nodular with infiltrative (49.7%), and nodular with superficial (26.0%). Conclusions: The majority of periocular BCC were located on the lower lid and classified histologically as nodular. Infiltrative BCC occurred more frequently than the superficial subtype. As the proportion of mixed BCC containing aggressive subtypes is high, surgical excision with margin control should be considered for periocular BCC.