Basal Cell Carcinoma

• The most common malignancy of the lid
• Most commonly seen in the lower lid and medial canthal region

Clinical Features

• Present as nodular, diffuse (morpheaform), ulcerated, or multicentric lesions
• Initially the lesion is a discrete nodule with or without ulceration, which eventually becomes ulcerated centrally with waxy rolled border
• Tumor infiltration to the adjacent structures can extend to the globe, bone and surrounding tissues and may cause frozen globe. This is most commonly seen with basal cell affecting the medial canthus
• Metastases are rare but recurrences are not uncommon

Management

• Excisional surgery and Mohs' surgical technique, which has become increasingly more popular because it is very effective in excising the entire tumor mass with microscopically proven tumor free margins
• Reconstructive surgery is usually required after Moh's surgery