Invasion of the lacrimal system by basal cell carcinoma

BACKGROUND. The rate of recurrence of basal cell carcinoma (BCC) in the per iorbital region is higher than that in other areas because of the spread of the tumor along barrier structures. OBJECTIVE. A better understanding of the biological behavior of BCC in this area, in particular as it relates to the lacrimal system, should improve t he outcome of surgery. METHODS. A study was made of two cases of BCC that developed in the periorb ital. region and invaded the lacrimal system. RESULTS. The tumors were found to have invaded the lacrimal system along th e mucosal epithelium. Magnetic resonance imaging (MRI) did not suggest any abnormalities in this area. In one patient, the tumor had infiltrated the n asal cavity without destruction of the periorbital bone and nasal cartilage . A preoperative fiberscopic examination clearly demonstrated the involveme nt of the nasal cavity in this case. CONCLUSION. The lacrimal system is often invaded by BCC that originates fro m the periorbital region. Physicians and surgeons need to be well aware of the possibility of such aggressive infiltration by BCC.