Basal cell carcinoma – of the eyelid / around the eye

Patient Information Leaflet

Introduction

Basal cell carcinoma, also commonly known as “Rodent Ulcer”, is a type of skin cancer that is often found around the eyes. Though it is a type of cancer, it is completely treatable with surgery and generally does not spread elsewhere in the body. However, if left untreated, it causes local tissue destruction and may spread to adjacent tissues, becoming difficult to treat.

It is the most common form of skin cancer in Europe, Australia and North America, with about 90 per cent of these occurring on eyelids. Approximately 53,000 new basal cell carcinomas are found in the UK each year.

Exposure to sunlight has been cited as one of the risk factors for basal cell carcinoma.

Diagnosis

It appears as a lump on the lid which grows slowly over time. The surface can become broken and can form an ulcer. It may continually scab over, but never heals completely and can sometimes bleed.

Sometimes, the diagnosis is clear from the appearance. When there is uncertainty, a small biopsy will be required to establish the diagnosis. Further management depends on the biopsy results.

Treatment

Once a diagnosis of basal cell carcinoma has been made, either in clinic or after biopsy, treatment is by surgery. The surgery is generally done in two stages.

In the first stage, the lesion (lump) is removed with healthy tissue all around it, and is then sent for microscopic examination to confirm complete removal. After the first stage, you will be sent home with a dressing, to return the following week for the second stage surgery.

In the second stage, if the microscopic examination shows that complete removal has been achieved, reconstruction of the wound will be done. The technique may vary depending on the site and size of the wound. This will be discussed with you in detail.  If complete removal has not been achieved, more tissue will be removed before proceeding with reconstruction.

Both stages of surgery can be done under local anaesthetic as a day case and you will be able to go home the same day.

Common risks of surgery

These include bleeding, infection, scarring, and lid notch. Sometimes, there may be a recurrence or a new lesion can appear. To monitor this, you will be followed up in the clinic for a few years after surgery.

After surgery

You will be given antibiotics to use and full advice regarding post-operative care will be given to you before you leave the hospital. You will be reviewed in the clinic a few weeks after surgery and on this visit, if needed, stitches will be removed.

Things to look out for after your procedure

Having had a basal cell carcinoma, although the risk is still low, you are potentially at higher risk than the general population of having another lesion in the same place or somewhere else.

Please be vigilant to notice any suspicious lumps on the skin, especially on the exposed parts, where you must bring it to the attention of your doctor.

Protect yourself from direct sunlight exposure by using sunglasses, sun screens and wide-brimmed hats.

Where can I find out more?

• NHS Choices patient advice article: Non-melanoma Skin Cancer

https://www.nhs.uk/conditions/non-melanoma-skin-cancer/

• British Skin Foundation

http://www.britishskinfoundation.org.uk/SkinInformation/AtoZofSkindisease/BasalCellCarcinoma.aspx

Opening times:

Monday – Friday, 9am – 4.30pm

Russells Hall (Eye Clinic) – (01384) 456111 ext. 3633

Russells Hall (appointments) – (01384) 456111 ext. 3625

What if I have any problems or questions after reading this leaflet?

If there is anything you do not understand, or you are concerned or worried about any part of the treatment, contact:

The Urgent Referral Clinic team at Russells Hall Hospital Eye Clinic on: 01384 456111 ext. 3633 (9am to 4.30pm, Monday to Friday).

Eye emergency, out of hours

In case of an eye emergency after the closing hours of the Eye Clinic (including weekends and bank holidays), please contact:

Birmingham and Midland Eye Centre on 0121 507 4440

The doctor on call is usually based at the Eye Centre, City Hospital, Dudley Road, Birmingham. They may need to call you back, and if necessary, they will arrange for you to visit them.

Note:

The information in this booklet is provided for information only. The information found is not a substitute for professional medical advice or care by a qualified doctor or other health care professional. Always check with your doctor if you have any concerns about your condition or treatment. This is only indicative and general information for the procedure.

Individual experiences may vary and all the points may not apply to all patients at all times. Please discuss your individual circumstances with your eye doctor.

Author:  Dr Alia Al-Mousawi, ophthalmology specialty trainee year 1
Dr Alexander Mitchell, ophthalmology specialty trainee year 2
Mr A Tripathi, consultant ophthalmologist

If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on 01384 456111 and ask for the relevant department who issued this leaflet.

If you have any feedback on this patient information leaflet please email dgft.patient.information@nhs.net

This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.

BCC/AT/AA/AM/ST/DP/09.2024/v4 – review 06.2027 DGH/PIL/02026