Search

The authors report 48 cases of basal cell epithelioma of the eyelids, either superficial or deeply invasive, and review the surgical treatment of these lesions. Certain basic principles of treatment are emphasized: the importance of early detection, necessary for simple, non-mutilating excision; the need to ensure immediate complete exeresis; the fact that eradication must be total without consideration for the reconstructive procedures to follow. Reconstructive surgery must always respect the structure of the eyelid in order to ensure a good esthetic and functional result.

A thirty-nine-year-old caucasian man presented with an ulceration of the scalp, developing on an alopecia. The scalp indeed had been burnt by boiling water when the boy was two. During childhood and youth microtraumatisms induced superficial wounds which always healed easily. Nine months ago, a new ulceration followed a new trauma; the wound did not heal, and lay on a dark brown area. A biopsy diagnosed a malignant melanoma. The whole alopecic area was resected, under the ulceration and the pigmented area, as well as the external surface and the diploe. The defect was covered with a free transplant of omentum, revascularized by microsurgical anastomoses to the external carotid artery and the external jugular vein in the parotid bed. The omentum was immediately covered with split-thickness skin grafts. Histologic investigations demonstrated the association of a melanoma developing on a Hutchinson melanotic freckle and a squamous cell carcinoma.