Symptoms of a basal cell carcinoma of the eye | Basal cell carcinoma of the eye

Symptoms of a basal cell carcinoma of the eye

The symptoms of a basal cell carcinoma are imprecise and are recognized by the affected person at a very late stage. The main reason is that the first skin changes caused by a basalioma are similar to everyday skin impurities and are often ignored. If the tumour grows, it forms a more classical form and corresponds roughly to a string of pearls laid in a bow.

The skin finding is not painful and is usually noticeable for cosmetic reasons. The weight loss typical of tumours is usually not present in basal cell carcinomas. If the basal cell carcinoma is located on the eyelid, it is possible that movement is impaired. Those affected are usually unable to open the eye properly, and the eye can also swell up accordingly, which can lead to impaired vision.

Diagnosis

In the case of advanced basal cell carcinoma, the eye diagnosis of the dermatologist is usually sufficient to have a corresponding suspicion. However, only the removal of the affected skin area and the pathological examination can provide certainty. In order to prevent cell transplantation, no biopsy is taken but usually the entire skin area is removed.

Therapy of a basalioma of the eye

For the treating physician, a basal cell carcinoma on or in the eye always represents a challenge, since the therapy is particularly difficult in this case. Usually, surgical removal of a basal cell carcinoma is the first choice. However, this is rarely possible, especially in the eye, without exposing the patient to great risk.

At least the removal of surrounding tissue, which should always be done for safety reasons when removing the tumour, is rarely possible without accepting massive complications. Therefore, in the case of a basal cell carcinoma of the eye, one of the other therapy options is usually resorted to. If it is localised on the eyelid, the decision is often made to use icing (cryotherapy).

This procedure is comparatively gentle and also shows a good success rate, at least for small superficial basaliomas. It can also be tried to heal the basal cell carcinoma by applying a skin cream followed by radiation. This is mainly used for large areas or unfavorably located skin areas.

The operation is the therapy of first choice before X-ray radiation, icing or drug therapy of the basal cell carcinoma. This applies especially to smaller basaliomas of the eyelid. In the case of larger tumours, it must be checked whether surgery is possible, as there may be problems in closing the surgical wound.

The operation is also known as microscopically controlled, radical excision in healthy tissue. This means that the basalioma is cut out (excision). The edges of the excised tissue are examined microscopically for residual tumour cells.

If cancer cells are still found in the edges, the incision is further excised at the site. Afterwards, another check is performed. On the one hand, this prevents too much tissue from being removed, on the other hand, a tumour recurrence (recurrence of the basal cell carcinoma at the same site) is rare.

Since a basal cell carcinoma of the eyelid can also lead to larger wounds, wound coverage with skin grafts may be necessary. If the basal cell carcinoma has grown in depth, cooperation not only with ophthalmologists but also with ENT and/or neurosurgeons is advisable.