Diagnostic accuracy of benign eyelid skin lesions in the minor operation theatre

Deokule, Sunil; Child, V.; Tarin, Shoaib; Sandramouli, Soupramanien

doi:10.1076/orbi.22.4.235.17248

Cited by 17 publications

(15 citation statements)

References 5 publications

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“…(9) Furthermore, accuracy was found to increase with greater professional experience, as was the case in the present study. (2,8,11) The accuracy of participants in determining the histological type of tumours was lower than in determining the presence of a malignancy, as shown in Tables 1 and 2. Of all malignant eyelid tumours, diagnostic accuracy was highest for BCC at 89%.…”

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

“…For example, Kersten et al found a high sensitivity in the clinical diagnosis of malignant lesions based on the experience of one very highly skilled professional. (8) This increases the internal validity of the study, but decreases its external validity because its results are less reproducible.…”

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

“…(12) Diagnostic accuracy tends to be lower for SCC, at approximately 36%. (2,3,8,9) The mortality rate of melanoma has made it the focus of increased attention. According to Boiko et al, 75% of general practitioners and 50% of consulting physicians can fail to diagnose a melanoma.…”

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

“…As there is a natural tendency to only submit suspected malignant lesions for pathological examination, retrospective studies cannot precisely evaluate diagnostic accuracy. (8) Previous studies evaluated the clinical accuracy of one, two, four, or more examiners. (1,3,4,8) This number can influence results.…”

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

“…(8) Previous studies evaluated the clinical accuracy of one, two, four, or more examiners. (1,3,4,8) This number can influence results. For example, Kersten et al found a high sensitivity in the clinical diagnosis of malignant lesions based on the experience of one very highly skilled professional.…”

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

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Accuracy of clinical examination in the diagnosis of eyelid lesions

Rossato¹,

Carneiro²,

Miyazaki³

et al. 2014

Revista Brasileira De Oftalmologia

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Objective: To analyze the accuracy of the clinical examination in the diagnosis of eyelid lesions. Methods: From the observation of thirtyfive photos of benign and malignant eyelid tumors were presented to ophthalmologists, for each picture, it was asked 3 questions: 1) the lesion is malignant or not; 2) if considered malignant, the probably histological type; and 3) the tumor is aggressive or not. The phisicians were divided into 9 groups, according to academic degree (time since graduation and Oculoplastics specialty or not). Answers were compared with the results of the histopathologic study of the surgically resected tumor. Results: In total, one hundred and six ophthalmologists were interviewed. The professional experience influenced the diagnosis of malignancy of the tumor, as the Group 1 (first year residents) had the lowest accuracy (64.5%), with lower estimated agreement (kappa = 0.13), and Group 5 (graduated 5 years ago and with expertise in Oculoplastics) the highest accuracy (77.3%), with better agreement (Kappa = 0.45), and presented the best parameters for other analyzed items. For the histological type diagnosis, accuracy was lower: group 1 had the worst performance, with 51.1% accuracy, while the best was for group 6 (graduated over 5 years and with expertise in Oculoplastics, 77.2% ). As for the criterion of tumor aggressiveness, the results were closer among the different categories. Ophthalmologists trained longer and without expertise in Oculoplastics also showed a low diagnostic accuracy for malignancy and to determine the histological type of tumor. Conclusion: The low accuracy of clinical diagnosis of eyelid tumors in the groups above reinforces the need to improve ophthalmic oncology knowledge in these groups.Keywords: Eyelid neoplasms/diagnosis; Eyelid neoplasms/pathology; Medical oncology; Health knowledge, atitudes, practice RESUMOObjetivo: Analisar a acurácia do exame clínico no diagnóstico de lesões palpebrais. Métodos: A partir da observação de trinta e cinco fotos de tumores palpebrais benignos e malignos que foram apresentadas a médicos oftalmologistas, para cada foto foram feitas 3 perguntas: 1) lesão maligna ou não? 2) se considerado maligno, o provável tipo histológico; e 3) tumor agressivo ou não? Os médicos foram agrupados em 9 grupos, de acordo com a formação profissional (tempo de formação e especialização ou não em Oculoplástica). As respostas foram comparadas com o resultado do exame histopatológico da peça retirada cirurgicamente. Resultados: No total, cento e seis médicos oftalmologistas participaram do estudo. A experiência do profissional influenciou no diagnóstico de malignidade do tumor, já que o grupo 1 (residentes de primeiro ano) apresentou a menor acurácia (64,5%), com menor concordância estimada (Kappa = 0,13), e o grupo 5 (formados há 5 anos e especializados em Oculoplástica) a maior acurácia (77,3%), com melhor concordância (Kappa = 0,45), além de apresentar as melhores medidas para os demais itens avaliados. Para diagnóstico do tipo histológico, a ac...

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Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

Section: Accuracy In Diagnosing Malignant Lesions Versus Experience Amentioning

confidence: 99%

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Accuracy of clinical examination in the diagnosis of eyelid lesions

Rossato¹,

Carneiro²,

Miyazaki³

et al. 2014

Revista Brasileira De Oftalmologia

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Surgical Management of Periocular Cancers: High- and Low-Risk Features Drive Treatment

Allen

2017

Curr Oncol Rep

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Mohs excision of basal cell carcinoma and squamous cell carcinoma continues to provide the greatest success in complete excision of the cancer, especially in those cases of high-risk disease including medial canthal location and recurrent disease. Sentinel lymph node biopsy has proven useful in the assessment of early regional metastasis in sebaceous cell carcinoma, melanoma, and Merkel cell carcinoma. The pathologic finding of perineural invasion is a high-risk feature in all periocular cancers, and adjuvant therapy should be considered. Targeted therapy shows great potential in situations that are not amenable to complete excision without sacrificing the globe. Identification of high- and low-risk features in eyelid cancers allows a stratified approach to treatment. While high-risk features may require adjuvant therapy, larger margins, and sentinel lymph node biopsy, low-risk features may allow topical therapy to adequately address the condition. Monoclonal antibodies and small molecule inhibitors show great promise in the treatment of extensive disease.

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