Condition: Basal cell carcinoma 2017-10-20T16:29:32+00:00

Basal cell carcinoma

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The best way to figure out whether your specific condition can be treated or not is to give us a call. We can answer any questions you have and help you clarify which treatment options might be suitable for you.

There are different treatment options available for this condition and the most common ones are listed below:

  • Basal cell carcinoma
Learn more about treatment options

Basal cell carcinoma

What is a Basal cell carcinoma?

A basal cell carcinoma (BCC) is a skin tumour which can grow on or near the eyelid. It is malignant and grows locally, invading the eyelids, cheeks, brow or orbit and should be removed by an oculoplastic surgeon. Removal is often done in collaboration with a dermatologist to make sure the tumour is completely removed. BCCs vary in size, from a few millimetres to several centimetres in diameter. They are painless but may ulcerate and bleed as they get larger.s69acutedacryo

Types of skin tumours

There are three main skin tumours which may occur on and around the eyelids:

    • The BCC (most common)
    • Squamous cell carcinoma (SCC)
    • Malignant melanoma (MM)

All of these tumours are related to sun exposure and are more common in fair-skinned people (with a low Fitzpatrick skin number).

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Video: Condition Basal cell carcinoma explained

Examination

The oculoplastic surgeon will first examine the eyelids and face. The suspected tumour is examined macroscopically (with the naked eye) and then under magnification (using a slit lamp). The suspected BCC is then measured, photographed, and a drawing of its location on, or near, the eyelids is done.

Particular attention is taken to look for telangiectactic blood vessels, pearly edge and ulceration, typical of a nodular BCC. Not all BCCs are nodular and can be difficult to detect, therefore, biopsy is essential. A more insiduous form of BCC is called a morpheic BCC, which is almost flat and spreads laterally and microscopically across the eyelid.

The treatment of a BCC depends on its type, size and location, so a biopsy is first performed under local anaesthetic. Once the diagnosis and type of the suspected BCC is confirmed, a treatment plan is drawn up.

Oculoplastic surgeons are trained to diagnose and treat skin cancer on the face, eyelids and periocular region and to undertake peri-orbital reconstructions. They work closely with consultant dermatology colleagues, who will use Mohs’ micrographic surgery to completely remove the BCC. Afterwards, the oculoplastic surgeon will do a face, eyelid or periocular reconstruction as necessary to restore the normal appearance and function of the face and eyelids. This may involve direct closure, flaps or grafts.

Treatment

Surgical Treatment of a Basal Cell Carcinoma

The main advantage of surgical excision is that excision margins can be examined to check the cells for tumour clearance.

The aims of treatment are to:

1. Establish the diagnosis clinically and by a small incisional biopsy
2. Completely excise the tumour (often using Mohs’ micrographic surgery)
3. Perform an oculoplastic reconstruction to maintain a normal appearance and function.

Different surgical techniques can be used to treat BCCs. One treatment is to shave, curettage and cauterise the tumour, another is to freeze off the BCC with liquid nitrogen (cryosurgery). The BCC can also be excised with a 4mm margin of normal tissue.

At Clinica London, we usually do an incision biopsy to establish the diagnosis and then use Mohs’ micrographic surgery in order to completely eradicate the tumour (this stage is done by the dermatologist) and finally we carry out the delicate eyelid and peri-orbital reconstruction, using specialist oculoplastic techniques.

Mohs’ micrographic surgery is a newer treatment than direct excision with a 4mm margin. Its advantage is that it looks at cells in the base of the tumour, not just at the edges, and insures that the entire tumour is removed in one setting.

The results with Mohs’ micrographic surgery are very good.

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What our patients say

“Dr Jane Olver was fantastic! She was so caring and sweet and it was clear that she knew what she was doing – very professional! I am absolutely over the moon with my results now!”
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“If you have a similar problem, Jane Olver is your woman – I wish I had found her at the start. I will be forever grateful for her care and expertise.”
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Heather M.
“Just keep up the good work Dr Khan. My wife, who accompanied me, and I were both very impressed by the care and consideration shown by the whole team when I had surgery. I just hope they haven’t lost the knack by the time I get my other eye fixed. joking apart the care of this team has made it a wonderful experience for me.”
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“Dear Professor Michel Michaelides , Thank you very much for your letter of the 4th September 2012. Ths means so very much to myself and Victor, during this terrible stressful time. Ever sind my first consultation with you, the caring dedication and understanding I have received from you has been priceless. Thank you with all my heart. Wishing you a healthy and happy future. Yours sincerely Doreen S.”
Doreen S.
“Dear Dr. Michaelides, I just wanted to express mine and my parents gratitude for arranging to see us all today and taking the time to answer all our questions. We left with a much greater understanding of the issues involved with genetic testing, the potential pattern of inheritance I have, and a renewed optimism over advances that could be happening in the field. It was also very helpful and reassuring to see Dr Amar again and be introduced to Jonathan the genetic counsellor – please do pass on our thanks to them as well. Yours sincerely Rachael S.”
Rachael S.
“Dear Professor Michaelides ,
Well done and thank you! You saw me last November for my annual RP assessment. You recommended to see the Glaucoma unit which I duly attended last week. (There was a delay because I had a cataract op in February)I do indeed have glaucoma as well as RP. Thankfully glaucoma is likely to be treatable with drops, so now at last the deterioration in my sight may be least partially arrested. I hope you will recommend to the retinal team that all RP suffers are tested for Glaucoma at fitting intervals. Yours sincerely, Edmund S.”
Edmund S.
“Dear Professor Michaelides ,
On behalf of my mother as well as myself, I would like to thank you for the consultation we had with you last Friday regarding my Usher Type 2/ RP condition. The knowledge and advice you shared with us was much appreciated. Today I received copy of the letter which you sent to my GP as record of the consultation. You might recall I mentioned that I have and indoor cycling frame which is great for an ex-road cyclist. If you should have any other patients who have to give up cycling on the road, I can recommend the “e-motion rollers” which is an American product and allows cyclists to ride their actual bike without modifications – suitable only for road bikes with high tyre pressure. Kind regards, Chris B.”
Chris B.
“Thank you for this, it’s nice to know you got the information you needed and were treated with respect. The team at Clinica London are good and the key thing, as you say, is seeing someone with the speciality in retinal degeneration. David “
David
“Dear Michel, My wife and I wish to thank you for your kindness and attention with regard to my poor eyesight. Your caring attitude and honest approach to help relieve my problem and find the best solution is overwhelming. And it is with this in mind we would like to express our sincere thanks for everything you have done for me. Kind regards, Maurice K”
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Matthew K.
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Jeffrey W.
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I just wanted to say thank you for seeing me at such short notice. I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.
I would also like to thank Ingrid, who was so lovely and very professional.
Best wishes, Catherine M.”
Catherine M.
“Thank you for forwarding the medical report. Please convey my thanks to Jane, I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon. Jeffrey W.”
Jeffrey W.
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Lorraine M.

“Dear Both,

Many thanks for taking care of my ptosis surgery today.
I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.

Many thanks, Charmaine”

Charmaine

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