Basal cell carcinoma of the eyelid
Introduction
Introduction to orbital basal cell carcinoma Basal cell carcinoma is the most common malignant tumor of the eyelid. The tumor is differentiated from the basal cells of the epidermis. Ultraviolet irradiation is the most important risk factor. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: orbital basal cell carcinoma
Cause
Causes of orbital basal cell carcinoma
(1) Causes of the disease
The occurrence of tumors is related to many factors. The cause of this disease is not very clear, and may be related to the irradiation of ultraviolet rays in sunlight. In addition, sputum-like basal cell carcinoma syndrome is an autosomal dominant hereditary disease, and its incidence rate Less than 1%, clinical manifestations of eyelids, facial and somatic multiple basal cell carcinoma, jaw cysts, bones, nervous system and endocrine system abnormalities, etc., first reported by Gorlin and Goltz in 1960, it is also known as Gorlin- Goltz syndrome.
(two) pathogenesis
The occurrence of tumors stems from the malignant transformation of normal cells in the body, changes in biological behavior, and the formation of autonomously growing new organisms, which are related to the changes of intracellular genetic material caused by tumorigenic factors. The tumors are differentiated from the basal cells of the epidermis, and the ultraviolet rays can be Causes changes in the structure of the genome within the cell.
Prevention
Orbital basal cell carcinoma prevention
There is no special preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
1, go to bed early and get up early, exercise the body. Insufficient sleep can reduce the body's immune function, and it is also easy to stimulate the fire, causing external injuries.
2. Quit smoking, drink less and drink coffee. Smoking is the most vulnerable to damage to the respiratory surface barrier and induces disease onset. Tobacco, alcohol and coffee all stimulate nervous excitement. Some people want to "eliminate tension and fatigue", but actually weaken the body's disease resistance.
3. Keep away from allergens and stay away from crowded places.
Complication
Orbital basal cell carcinoma complications Complications orbital basal cell carcinoma
Orbital basal cell carcinoma can invade the lacrimal passage along the conjunctiva and develop into the orbit and nasal cavity, causing complications of different clinical manifestations.
Symptom
Orbital basal cell cancer symptoms Common symptoms Conjunctiva tears area gray erythema scaly scarring nodules pearl pimples
Most of the tumors occur in the lower jaw, accounting for about 2/3 of all cases, 15% of the internal iliac crest and upper iliac crest, and the lowest of the external iliac crest, about 5%.
Nodular ulcerative basal cell carcinoma is the most common clinical manifestation. It is high in appearance and has a hard "pearl-like" nodule. The surface of the capillaries expands. As the nodule grows, the central ulcer develops and slowly develops to the periphery. The surrounding edge is thickened and striated, also known as intractable ulcer.
Pigmented basal cell carcinoma is similar in morphology to nodular ulcer. The tumor is a nodular or nodular ulcer, but has melanin pigmentation, grayish blue or grayish black. It can be misdiagnosed as malignant melanoma. This type of basal cell carcinoma There were no significant differences in age, gender, location, duration of disease, and recurrence rate.
Hard-spotted or sclerosing basal cell carcinoma is gray-white hard plaque with unclear borders. Because it is flat, it is not easy to be found clinically, and generally does not form ulcers. However, this type of lesion is invasive and can invade deep dermis or sputum. Periosteum can also invade the eyelids and paranasal sinus, nodular ulcer type, pigmented and sclerotic type easily occurs on the face, superficial type can occur in the eyelid, but more in the trunk, the lesion is often multiple, the appearance is erythema scales Plaque, the perimeter can be a thin pearl-like, can spread to the surrounding, the border is still clear, can be accompanied by superficial ulcers and scarring.
Examine
Examination of orbital basal cell carcinoma
Histopathological changes: histologically can be divided into:
1 nodular ulcer type;
2 pigmentation;
3 hard spot or hardened type;
4 superficial;
5 fiber epithelioma;
6-like basal cell carcinoma syndrome;
7 linear basal cells;
8 common follicular basal cells, most of the lesions belong to the first 4 types, the latter 2 type is very rare, basal cell carcinoma originates from the primitive pluripotent epithelial germ cells of the basal layer of the epidermis, and the cancer cells resemble basal cells and are oval. Or fusiform, deep nuclear staining, less cytoplasm.
1. Solid basal cell carcinoma: This type is more common. There are multiple cancer cell clusters of different sizes and different shapes in the dermis. The cells around the cancerous group are fence-like, and the cancerous cell and the surrounding fibrous interstitial often appear. Blank, this is a characteristic of basal cell carcinoma, which can be distinguished from squamous cell carcinoma.
2. Pigmented basal cell carcinoma: There is a large amount of melanin in basal cell carcinoma, melanin is located in cancer cells, melanocytes in melanocytes and interstitial cells in the melanin, and the authors analyzed 100 cases of orbital basal cell carcinoma and found pigmentation. There is no significant difference in age, sex, location, etc. between basal cell carcinoma and non-pigmented.
3. Superficial basal cell carcinoma: The tumor is multifocal, connected to the epidermis, and protrudes into the superficial dermis without obvious interstitial.
4. Hard-spotted or sclerosing basal cell carcinoma: Cancer cells are usually arranged in a single layer or a double layer, which is strip-like and widely distributed in the interstitial of a large number of fibrous tissues, which can invade the muscles or fat of the eyelids.
5. Fibrous epithelial basal cell carcinoma: The cords formed by cancer cells are in a lace-like shape.
6. Keratinizing basal cell carcinoma: keratinocytes and horn cysts are seen in undifferentiated cancer cells. The nucleus of keratinization is fusiform, the cytoplasm is weakly eosinophilic, and the horn cyst is composed of completely keratinocytes.
7. Cystic basal cell carcinoma: There is a cyst in the center of the cancer cell.
8. Adenoid basal cell carcinoma: Cancer cells constitute a tube-like or adenoid structure.
Basal squamous cell carcinoma is a variant of basal cell carcinoma. In basal cell carcinoma, there are components of squamous cell carcinoma such as squamous cell carcinoma nest or keratinized bead. The lesion is more aggressive than basal cell carcinoma, and metastasis can occur. Between basal cell carcinoma and squamous cell carcinoma.
Basal cell carcinoma and hair epithelioma are histologically similar. It has also been reported that both are present in one patient. Hair epithelial tumors originate from hair growth cells and are autosomal dominant hamartomas, usually present in early childhood. For multiple, scattered in the shape of a small, pink nodule, usually 2 ~ 8mm, distributed in the face, scalp, neck and upper torso, ulceration on the surface of the lesion is not common, the tumor is embedded in the significantly dense fibrous interstitial There is very little inflammatory infiltration.
1. Ultrasound examination: Direct exploration on the surface of the lesion, visible irregular shape of the lesion, the boundary is unclear, the internal echo is moderate, the distribution is uneven, CDI can be seen that the blood flow inside the tumor is rich.
2. CT examination: The eyelids are irregularly thickened, the boundary is unclear, and the boundary is uneven. In addition, CT can show the depth of invasion and bone destruction in the tumor, and can also show the metastasis of the lungs and liver.
Diagnosis
Diagnosis and differentiation of orbital basal cell carcinoma
diagnosis
According to clinical manifestations, such as nodular ulcer type with edge ridge and central ulcer characteristics, pigmentation can be seen pigmentation, but the diagnosis requires biopsy confirmed by histopathology, imaging examination can help determine the extent of the lesion.
Differential diagnosis
Basal cell carcinoma needs to be differentiated from melanoma, squamous cell carcinoma, meibomian gland adenocarcinoma, papillary sweat gland adenoma, and malignant tumors. The main means of identification depends on pathological examination.
