🩺 Case Report: Basal Cell Carcinoma of the Right Lower Eyelid in an Elderly Female

Patient Profile: An 80-year-old female presented with a slowly enlarging lesion on the right lower eyelid. She had no significant past medical history and no known family history of skin cancer. The lesion had been present for approximately 10 months and had gradually increased in size.

🔍 Clinical Presentation

On examination, a 1 cm pearly, nodular lesion with central ulceration and rolled borders was observed on the central right lower eyelid. The surface showed crusting but telangiectasia was not seen. The lesion was firm, non-tender, and adhered to the underlying tissue. There was no associated pain, discharge, or visual disturbance. No regional lymphadenopathy was noted.

🛠️ Treatment

The patient underwent surgical excision under local anesthesia with a 4 mm margin of clinically normal skin. The excised tissue was sent for histopathological analysis. Reconstruction of the eyelid defect was performed using a direct closure technique, preserving eyelid function and contour.

🧬 Histopathology

Confirmed nodular basal cell carcinoma
Clear surgical margins
No involvement of nerves, blood vessels, or lymphatics

✅ Outcome

The wound healed uneventfully with minimal scarring. Eyelid function remained intact, and there was no distortion of the lash line or ocular surface. The patient was advised on sun protection and scheduled for regular dermatologic follow-up. No recurrence was noted at 6-month review.

📌 Discussion

Basal cell carcinoma is the most common periocular malignancy, particularly in elderly patients. The lower eyelid is the most frequent site due to chronic sun exposure. Early diagnosis and complete excision are critical to prevent local invasion and preserve ocular function. In this case, timely intervention and appropriate surgical technique resulted in very good oncologic and cosmetic outcomes.

🩺 病例報告：高齡女性右下眼瞼基底細胞癌

病人概況：一名 80 歲女性，右下眼瞼出現一個逐漸增大的病灶。病人過往病史良好，無皮膚癌家族史。該病灶已存在約 10 個月，並持續緩慢增大。

🔍 臨床表現：檢查發現右下眼瞼中央位置有一顆約 1 公分大小的珍珠狀結節，中央潰瘍，邊緣呈捲曲狀。表面有結痂，但未見毛細血管擴張。病灶質地堅實，無壓痛，與下方組織黏連。病人無疼痛、分泌物或視力障礙，亦未見區域性淋巴結腫大。

🛠️ 治療方式：病人於局部麻醉下接受手術切除，並保留 4 毫米的正常皮膚邊緣。切除組織送交病理化驗。眼瞼缺損以直接縫合方式修復，保留眼瞼功能與外觀輪廓。

🧬 病理結果：

確診為結節型基底細胞皮膚癌
切除邊緣清晰，無殘留癌細胞
無神經、血管或淋巴侵犯跡象

✅ 術後結果：傷口癒合良好，疤痕極小。眼瞼功能完整，睫毛線與眼表未見變形。病人獲建議加強防曬，並安排定期皮膚科覆診。六個月後未見復發。

📌 討論：基底細胞癌是眼周最常見的惡性腫瘤，尤以高齡患者為主。下眼瞼因長期日曬而成為好發部位。早期診斷與完整切除對防止局部侵犯及保留眼部功能至關重要。本案例中，及時介入與適當手術技術成功達致良好的腫瘤控制與美學效果。