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Eyelid Cancer and Reconstruction PowerPoint Presentation

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Description : Check out this medical presentation on Eye and Eyelid Cancer, which is titled "Eyelid Cancer and Reconstruction", to know about Eyelid Cancer, and Benign Lesions and Malignant Lesions.

Tags : Eye, Eyelid Cancer, Eyelid Cancer, Reconstruction, Benign Lesions, Malignant Lesions

Published on : May 18, 2021 | Views : 1486 | Downloads : 4

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Eyelid Cancer and Reconstruction Laurence Z. Rosenberg,M.D. Southeastern Plastic Surgery
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Benign Lesions Chalazion
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Benign Lesions Chalazion Caused by a blocked duct from a meibomian gland This is not a sty (glands of Zeis) Initial treatment warm compresses May require surgical excision
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Benign Lesions Chalazion Cautious observation for a limited time. If the lesion is not getting better, refer or do a biopsy. If you excise the lesion, always send the specimen to pathology
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Benign Lesions Trichoepithelioma
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Benign Lesions Trichoepithelioma Benign lesion, often develop after puberty May be numerous Obsevation is indicated
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Benign Lesions Trichoepithelioma Desmoplastic trichoepithelioma may resemble a basal cell carcinoma If there is change, never hesitate to biopsy
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Benign Lesions Verruca
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Benign Lesions Verruca Caused by Human Papilloma Virus. Over 150 strains Filliform warts: long thin lesions on the face Different from genital warts
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Benign Lesions Verruca Usually clear up in children without treatment May be more persistent in adults Multiple treatments, but on eyelid, careful excision o cauterization 20% recurrence
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Benign Lesions Inclusion Cyst
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Benign Lesions Inclusion Cyst Often called a sebaceous cyst, this is a misnomer May resemble a basal cell carcinoma May become inflamed or infected
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Benign Lesions Inclusion Cyst Usually no treatment is required Often removed for appearance or because of infection Remove entire cyst and punctum if possible.
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Benign Lesions Nevus
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Benign Lesions Nevus Atypical Nevus Size >5 mm diameter Ill-defined or blurred borders Irregular margin resulting in an unusual shape Varying shades of color (mostly pink, tan, brown, black) Flat and bumpy components
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Benign Lesions Nevus Dysplastic Nevi –pathologic diagnosis The lesion may be a junctional naevus or more frequently a compound naevus (the cells are found at the epidermodermal junction and within the dermis). The nevus cells form a row along the dermoepidermal junction (called lentiginous proliferation), with or without nevus cells in nests (called theques).
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Benign Lesions Nevus Dysplastic Nevi –pathologic diagnosis These theques are often irregular in size and shape and may 'bridge' or join together. The cells may be odd-looking i.e. they have cytologic atypia, and they may be spindle-shaped (elongated) or epithelioid (resembling epidermal keratinocytes i.e., broad). There may be fibrosis or scarring in the dermis.
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Benign Lesions Nevus Dysplastic Nevi –pathologic diagnosis Inflammatory cells may infiltrate the lesion. Associated blood vessels may be increased in number or enlarged.
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Benign Lesions Nevus Treatment May be for cosmetic purposes Excision dependent on the degree of atypia (moderate or severe) not an exact science
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Malignant Lesions Basal Cell Carcinoma
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Malignant Lesions Basal Cell Carcinoma Most common human cancer More common in fair skinned people May be heritable: Basal Cell Nevus Syndrome
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Malignant Lesions Basal Cell Carcinoma Nodular BCC Most common type on the face Small, shiny, skin colored or pinkish lump Blood vessels cross its surface May have a central ulcer so its edges appear rolled Often bleeds spontaneously then seem to heal over
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Malignant Lesions Basal Cell Carcinoma Superficial BCC Often multiple Anywhere Pink or red scaly irregular plaques Slowly grow over months or years Bleed or ulcerate easily
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Malignant Lesions Basal Cell Carcinoma Morpheaform BCC Also known as sclerosing BCC Usually found in mid-facial sites Prone to recur after treatment May infiltrate cutaneous nerves (perineural spread)
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Malignant Lesions Basal Cell Carcinoma Pigmented BCC Brown, blue or greyish lesion Nodular or superficial histology May resemble melanoma
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Malignant Lesions Basal Cell Carcinoma Basisquamous BCC Mixed BCC and Squamous Cell Carcinoma More Aggressive
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Malignant Lesions Basal Cell Carcinoma Treatment Currettage and cautery: Margins unknown Excision: Margins known, but not circumferential Mohs: Best for high risk lesions, most definitive margin assessment Photodynamic Therapy: superficial BCC. Lower Cure Rate Imiquimod: Immune modulator Radiation: May be used in elderly or as adjuvant therapy
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Malignant Lesions Squamous Cell Carcinoma
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Malignant Lesions Squamous Cell Carcinoma Directly related to UV exposure Smoking Chronic wounds Human Papiloma Virus
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Malignant Lesions Squamous Cell Carcinoma Treatment: Surgery Excision Mohs Patient may require assessment of the lymph nodes Large tumors may require pre-operative radiographic imaging
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Malignant Lesions Squamous Cell Carcinoma 5% metastasize to other sites more likely in transplant patients, old age, alcoholics etc. May require adjuvant radiation therapy
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Malignant Lesions Melanoma
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Malignant Lesions Melanoma Cancer of the melanocytes Prognosis dependent of tumor thickness Stage IA: Melanoma <1.0mm Stage IB: Melanoma is <1.0mm with ulceration or Mitoses >1 or > 1.0mm and ≤ 2.0mm Stage IIC: Melanoma > 4.0mm, with Ulceration Stage IIIC: Nodal Involvement or Intransit spread Stage IV: Spread to distant organs
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Malignant Lesions Melanoma Stage IA: The 5-year survival rate is around 97%. The 10-year survival is around 95%. Stage IB: The 5-year survival rate is around 92%. The 10-year survival is around 86%. Stage IIC: The 5-year survival rate is around 53%. The 10-year survival is around 40%. Stage IIIC: The 5-year survival rate is around 40%. The 10-year survival is around 24%.
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Malignant Lesions Melanoma Stage IV: The 5-year survival rate for stage IV melanoma is about 15% to 20%. The 10-year survival is about 10% to 15%.
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Malignant Lesions Melanoma Treatment: Dependent on tumor thickness in-situ 0.5cm < 1.0mm 1cm 1.0 – 2.0mm 1 – 2cm >2.0mm 2cm If the tumor is > 1.0mm thick, or ulcerated or mitotic index ≥ 1 Perform sentinel lymph node biopsy
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Reconstruction Mohs defect 45 by 55mm 50% lower Lid 30% Upper lid Resection of lateral canthus Loss of temporal skin
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Reconstruction Repair of the eyelid, like all reconstruction: Knowledge of the anatomy Function of the part to be reconstructed Application of technique
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction
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Reconstruction Lower Lid Posterior Lamella Temporalis fascial flap Lower Lid anterior Lamella Cervical facial flap Reconstruct upper lid Primary attachment to New lower lid
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Reconstruction