EYELID BASAL-CELL CARCINOMA WITH INTRACRANIAL EXTENSION

We describe a case of basal cell carcinoma (BCC) situated on the exter nal upper margin of the right eyelid in a young man aged 28 years. The tumor was diagnosed as an ''extended wart in a degenerative phase'' a nd removed during reconstructive plastic surgery. No pathologic examin ation was performed. Seven years later, the operation was followed by a first recurrence. Pathologic examination was then performed, and the diagnosis was BCC. Therapy was with radiotherapy and chemotherapy. Su bsequent recurrences were treated with radiotherapy and surgery (enucl eation, exenteration of the orbit), but the evolution of the tumor was not halted. It ended 25 years after its first manifestation with the death of the patient of a hemorrhage of the upper airways during an op eration, the aim of which was to reexamine the orbital cavity. The aut opsy revealed intracranial extension of the tumor, and all the histolo gical examinations confirmed the diagnosis. No histopathological featu re was found that could differentiate a particularly agp aggressive na ture of the tumor. Basal cell carcinoma is a tumor more frequently enc ountered in elderly patients. Its appearance in a young subject may ca use grounds for suspicion, requiring initial radical surgical treatmen t and careful surveillance of the evolution of the lesion. This case d ocuments the fatal consequences that may arise from the failure to rec ognize BCC in its first manifestation and highlights the ineffectivene ss of repeated radiation and surgical therapy against continual recurr ence.