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Letter to the Editor
Massive basal cell carcinoma in a schizophrenic patient: treatment options and constraints
  1. MOHAMMED MUHTASEB,
  2. JANE M OLVER
  1. Eye Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
  2. Pathology Department
  1. SHARON CONSTANTINE
  1. Eye Department, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK
  2. Pathology Department
  1. Jane M Olver

https://doi.org/10.1136/bjo.85.1.110h

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    Editor,—Basal cell carcinoma (BCC) is the most common malignant tumour of the eyelids and face. Factors which increase the chance of orbital invasion include a medial canthal location, slow indolent growth, morpheaform growth pattern, surgical recurrence, advanced presentation, and neglect. Orbital invasion predisposes to intracranial involvement by direct or perineural spread. Management of orbital invasion is difficult and requires a multidisciplinary team approach for radical surgery and/or radiotherapy.

    We present a 76 year old Ukranian man with a neglected tumour on his forehead which had spread over several years to involve the upper eyelids, anterior orbits, and ethmoid sinuses.

    CASE REPORT

    A 76 year old man with a long history of untreated forehead BCC complained of deteriorating vision in his right eye and ocular discharge. He had been admitted by the care of the elderly unit, for social reasons. He was a known paranoid schizophrenic treated with psychotropic drugs. Four years previously his physician had measured the lesion as being 2 cm × …

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