Atypical Recurrent Presentation of Histologically Aggressive Type of Basal Cell Carcinoma with a Challenging Management- A Rare Case Report

Basal Cell Carcinoma (BCC) is the most common type of eyelid malignancy among white race individuals but is rare among blacks and Indians. BCC predominantly affects the sun exposed parts like the neck, back and face (88-90%). These tumours are mostly located on the lower eyelid margin and the medial canthus as upper eyelids are protected from the Ultraviolet (UV) sunrays by the eyebrows and superior orbital margin. Although BCC seldom metastasizes, it is nonetheless considered malignant, since it can infiltrate adjacent tissues and cause substantial deformity and destruction. Here, authors have reported a rare case of 55-year-old female patient with recurrence of surgically treated BCC of upper eyelid involving eyebrow. Surgical excision is the most common employed treatment of choice in extensive tumours. Patient had extensive recurrent spread of BCC in left upper eyelid with multiple small ulcers in and around the left eye with pain and no Perception of Light (PL) vision. Exenteration of left eye was done followed by split skin autografting at the site. BCC is usually not fatal, but early diagnosis and appropriate treatment promises better functionality and aesthetic outcome.