BASAL-CELL CARCINOMA INVOLVING THE LACRIMAL CANALICULUS - A DOCUMENTED MECHANISM OF TUMOR SPREAD

BACKGROUND. Basal cell carcinoma (BCC) is the most common malignant tu mor of the eyelid and periocular tissues but rarely involves the lacri mal system. In addition, BCC in this location frequently recur due to inadequate margin control. A further understanding of the pathophysiol ogy of periocular BCC was addressed. OBJECTIVE. To report two rare cas es of BCC involving the lacrimal system and to account for subtle clin ical features yet extensive tissue spread of periocular BCC. METHODS. Using the Mohs micrographic surgical technique, we describe two patien ts with a BCC involving the lacrimal system that histologically tracke d beyond clinically apparent margins. RESULTS. Spread of BCC along muc osal surfaces is documented. CONCLUSION. Rare involvement of the lacri mal system by a BCC is reported in two patients. Superficial histologi c involvement can explain the ability of BCC to extend locally and esc ape adequate treatment. (C) 1997 by the American Society for Dermatolo gic Surgery, Inc.