Periocular squamous cell carcinoma

Abstract

Squamous cell carcinoma (SCC) is the second most common eyelid malignancy and its incidence is increasing. Because of its variable clinical presentation, SCC may be difficult for even the experienced clinician to diagnose. Hence, all suspicious lesions warrant biopsy. As SCC behaviour may range widely in aggression, management should be individualized based on tumour (e.g. size, location, grade, histological subtype, previous recurrence, perineural invasion) and patient factors (e.g. age, health). Treatment of eyelid SCC should include margin control whenever possible for the highest cure rate in this high-risk area. Immediate histological monitoring of surgical margins with frozen sections or Mohs' micrographic surgery also allows for smaller margins of excision in an area where tissue conservation is important. Other special considerations in the periocular area include maintaining a high level of suspicion for perineural invasion as this may be associated with a poorer prognosis.

Perineural invasion in carcinoma of the cervix uteri—prognostic impact

“…Abstracting the data from our study and the few ones reported in the literature, PNI might represent an additional poor prognostic factor in patients with surgically treated CX. In cutaneous squamous cell carcinoma the histologic diagnosis of PNI might be an indication for adjuvant therapy (Limawararut et al 2007). Beitler et al (1997), in their study of recurrent CX treated with exenteration procedure, suggested that radiation therapy might be beneWcial to patients representing PNI.…”

Orbital exenteration for advanced periorbital non-melanoma skin cancer: prognostic factors and survival

“…6 While SCC is a less common periocular malignancy, 20-30% of periocular SCC is multifocal at the time of diagnosis 1,7 with regional involvement in between 1 and 24.3% of cases. 7,8 Perineural invasion occurs in 3-14% of squamous cell carcinomas and is associated with a worse prognosis. 1,8 SGC is a rare, aggressive cancer that not only spreads locally but also demonstrates significant metastatic potential with lymph node involvement present in 30% of cases.…”

“…7,8 Perineural invasion occurs in 3-14% of squamous cell carcinomas and is associated with a worse prognosis. 1,8 SGC is a rare, aggressive cancer that not only spreads locally but also demonstrates significant metastatic potential with lymph node involvement present in 30% of cases. 9,10 Reported overall mortality from SGC ranges from 18 to 30% and tumors that involve the upper and lower eyelids, are greater than 10mm in diameter, demonstrate pagetoid spread, or invade the orbit have a worse prognosis.…”

Squamous Cell Carcinoma of Eyelid, Periocular, and Periorbital Skin

“…Numerous studies have confirmed the inaccuracy of preoperative clinical diagnosis, by even experienced observers. [7][8][9][10][11][12] Fifteen of 51 lesions in our series were thought to be basal cell carcinoma and only 32 lesions (62.7%) were correctly identified as squamoproliferative lesions preoperatively. 7 Another study stated that the clinical diagnosis of SCC of the skin was confirmed in 51% of cases.…”