Suspicious Growths Around the Eyes: Beware !

Growth of periocular basal cell carcinomas.
Tan E, Lin FP, Sheck LH, Salmon PJ, Ng SG.
Br J Dermatol. 2015 Apr;172(4):1002-7. doi: 10.1111/bjd.13470. Epub 2015 Feb 8.

Basal Cell Carcinoma (BCC) is the most common skin cancer and is thought to arise from the hair follicle. It is therefore not found in regions such as the glabrous skin of the palms and soles.

It is traditionally regarded as a slow growing tumor. It infrequently metastasizes but the main problem is local invasion which can lead to catastrophic tissue loss if left untreated: usually a surgical excision with narrow margins is sufficient but in “tissue precious” area such as the nose, Mohs micrographic surgery can be used.

Skin growths around the eyes can be due to a variety of reasons (see skin problems around the eyes: CLICK HERE). However the following study suggests that periocular BCC grows fast

In this study from New Zealand the authors evaluated 112 patients with a total of 115 periocular BCCs
-The lesions were measured at the first appointment with the specialist and when the patient underwent Mohs surgery.
Results show that the average wait time for the surgery was around 6 months (157 +/- 87 days). The lesions grew on average by 0.76mm in diameter or increased in surface 11.2mm2 every month ! (The mean average growth overall was 41.9mm2)
Risk factors include large tumors, large initial size and male gender

When assessing BCCs clinically (with a dermatoscope..of course !) in delicate areas one could decide to wait and reevaluate, do a biopsy in delicate areas. The two last methods yield scars but if there is the slightest diagnostic doubt, these are the methods to use to avoid additional tissue loss.

Article selection: Prof Dr Jean-Hilaire Saurat – dermatologist. Geneva, Switzerland