MIXED-TYPE BASAL-CELL CARCINOMA OF THE EYELIDS

A retrospective histopathologic review of 97 patients with basal cell carcinoma of the eyelid was performed to determine the prevalence and behavior of tumors with a mixed pattern of growth. A mixed type basal cell carcinoma was defined as a tumor having a significant nodular or ulcerative component combined with an infiltrative component. Histolog ic classification of the 97 tumors yielded four (4.1%) that were multi centric, 67 (69.1%) that were nodular, one (1%) that was ulcerative, 1 3 (13.4%) that were infiltrative, and 12 (12.4%) that were the mixed v ariant. Follow-up was obtained on 8 of the 12 patients with mixed basa l cell carcinoma. Three tumors recurred, but there were no tumor-relat ed deaths. One of these patients underwent numerous eyelid resections over a 2-year period and then underwent an orbital exenteration. The a uthors conclude that mixed type basal cell carcinomas are not infreque nt and behave as aggressively as basal cell carcinomas of the morphea type. A greater awareness and recognition of mixed type basal cell car cinomas by ophthalmologists and pathologists should result in fewer re currences and better patient management.