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Related Experiment Videos

Red eye and a rodent ulcer.

Daya Papalkar1, Shanel Sharma, Ian C Francis

  • 1Department of Ophthalmology, Prince of Wales Hospital, Randwick, Sydney, Australia.

Ophthalmic Plastic and Reconstructive Surgery
|March 22, 2006
PubMed
Summary

A delayed diagnosis of basal cell carcinoma (BCC) occurred in a 58-year-old woman due to patient denial and self-concealment. This extensive facial BCC led to bone erosion and was initially missed, despite eye symptoms.

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Area of Science:

  • Dermatology
  • Ophthalmology
  • Oncology

Background:

  • Basal cell carcinoma (BCC) is the most common type of skin cancer, typically slow-growing.
  • Advanced BCC can cause significant local destruction if left untreated.
  • Ocular symptoms can sometimes be the presenting complaint in periocular skin cancers.

Observation:

  • A 58-year-old woman presented with acute vision loss and red eye, suspected endophthalmitis.
  • Examination revealed extensive facial ulceration involving the forehead, nose, and eyelid, with exposed bone.
  • The lesion was a basal cell carcinoma that had progressed over 30 years, concealed by the patient.

Findings:

  • Computed tomography showed erosion of the frontal bone and dural exposure.
  • Histopathology confirmed the diagnosis of basal cell carcinoma.

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  • Despite multiple eye assessments, the underlying extensive BCC was missed due to the patient's concealment.

    • Implications:

    • Highlights the importance of thorough physical examination, including assessment of concealed areas.
    • Underscores the potential for advanced skin cancers to present with atypical symptoms.
    • Emphasizes the role of patient denial and psychosocial factors in delayed cancer diagnosis and treatment.