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Confident complete excision of lid margin BCCs using a marginal strip: an alternative to Mohs' surgery
  1. Narendra Dhingra (ndhingra{at}doctors.org.uk),
  2. Adam Gajtasky,
  3. Jim Neal,
  4. Achyut Mukherjee,
  5. Carol M Lane
  1. Cardiff Eye Unit, United Kingdom
  2. Cardiff Eye Unit, United Kingdom
  3. Department of Histopathology, University Hospital of Wales, United Kingdom
  4. Cardiff Eye Unit, United Kingdom
  5. Cardiff Eye Unit, United Kingdom

    Abstract

    Aims: To report a new technique of tissue preparation, employing a marginal strip, following excision of eye-lid basal cell carcinomas (BCC) and to report the long-term results of BCCs excised using this technique.

    Method: Following excision of eye-lid BCC with a safety margin of 4 mm, a 1mm strip was excised along the whole perimeter from the margin of the freshly excised specimen. This marginal strip had intact conjunctival mucosa along one edge and skin along the other. The marginal strip and the central tumour mass were then fixed immediately in formal saline and subjected to conventional histopathology.

    Results: Of the 61 patients who completed a 5 years follow-up, the results of 28 eye-lid BCCs that were within 4mm of the lid margin are reported. The marginal strip was clear in 22 specimens and had presence of residual tumour in its margin in 6 specimens. The 6 cases were further managed by observation (2), further surgical excision using marginal strip (2) and by Mohs' surgery (2).

    Conclusion: Marginal strip examines the entire resection margins analogous to Mohs' technique and we recommend its use in lid margin where tarsus is present throughout the specimen and more than 4mm from the lid margin.

    • BCC
    • Mohs' surgery
    • marginal strip

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