Radiation Therapy for Eyelid Basal Cell Carcinoma - A Case Report

Case Report

Austin J Clin Ophthalmol. 2015;2(2): 1043.

Radiation Therapy for Eyelid Basal Cell Carcinoma - A Case Report

Cardoso MS1*, Monteiro SG1, Pires J1, Mariano M1, Castela G2, Marques RV3 and Lopes N1

1Department of Ophthalmology, Centro Hospitalar do Baixo Vouga, Portugal

2Department of Ophthalmology, Centro Hospitalar e Universitàrio de Coimbra, Portugal

3Department of Radiation Therapy, Portuguese Institute of Oncology Francisco Gentil Coimbra, Portugal

*Corresponding author: Cardoso MS, Department of Ophthalmology, Centro Hospitalar do Baixo Vouga - Hospital Infante D. Pedro, Avenida Artur Ravara, 3814-501 Aveiro

Received: January 20, 2015; Accepted: February 26, 2015; Published: February 27, 2015


Basal cell carcinoma is the most common type of eyelid cancer. Although rarely associated with metastatic disease, it is locally invasive and can cause significant destruction and cosmetic deformities. The first line treatment is usually surgical excision, but currently numerous alternatives are available; the radiation therapy is one of these therapeutic options.

A case report of an eyelid basal cell carcinoma with intraorbital extension successfully treated with radiation therapy, in a female patient with 87 years of age, is presented. Complementary tests results are described, as well as clinical evolution.

We concluded that radiation therapy is a good treatment option for unresectable tumors and for patients who are unable to tolerate more invasive methods.

Keywords: Basal cell carcinoma; Eyelid; Orbit; Treatment; Radiation therapy


Basal Cell Carcinoma (BCC) is a slow-growing and locally invasive skin tumor which rarely metastasizes, derived from cells of the basal layer of the epidermis [1]. It is the most common type of cancer in Europe, Australia and the USA, affecting predominantly individuals of Caucasian race and older than 60 years [2-4]. The most significant risk factors appear to be exposure to ultraviolet radiation and genetic predisposition [5]. It usually occurs on sun-exposed areas of skin, and therefore about 74% of cases arise in the head and neck [6]. Although relatively indolent, this tumor can be quite destructive to cause significant cosmetic deformities [7]. Currently, there are several treatment modalities for BCC, such as surgical excision, radiotherapy, topical 5% imiquimod cream, cryotherapy and photodynamic therapy [8]. The therapeutic choice will depend on many factors, including the histologic type of tumor, its size and location, patient's age, general health and expectations, treatment availability and also in the experience and preferences of the specialist [9]. The first line treatment is usually surgical excision, showing the lowest failure rates [10]. However, radiation therapy is a very effective treatment strategy, particularly for patients with primary lesions requiring difficult or extensive surgery [11,12]. The aims of any therapy selected for BCC treatment are to ensure complete removal, the preservation of function and a good cosmetic outcome [4].

Case Report

An 87-year-old Caucasian woman presented with an extensive mass (25 mm in its major axis) located in the temporal portion of the left lower eyelid that had been slowly growing for the last two years (Figure 1A). As ophthalmologic antecedents, she had phthisis bulbi in her left eye caused by glaucoma. The histopathological analysis of the lesion revealed a basal cell carcinoma without lymphatic or vascular invasion. Computed Tomography (CT) of the orbits showed a well-circumscribed mass in the infratemporal region of the left orbit with intraorbital extension (Figures 1B, 1C, 1D and 1E). The tumor was classified as T3N0M0.