Myiasis in Patients after Surgery, Brachytherapy, and Exenteration of the Orbit Due to Basal Cell Carcinoma

Massive infiltration of the orbital tissues by dipterous fly larvae (ophthalmomyiasis) occurs throughout the world but is very rare in middle Europe countries. We report a patient with periocular basal cell carcinoma treated by surgical excisions, due to relapses followed by a high dose rate of HDR Ir192 brachytherapy which led to the necessity of orbital exenteration. The patient after many surgical operations and radiotherapy for recurrent periocular basal cell carcinoma through the years. Since 2021 the patient has not attended doctors during the COVID pandemic period. Due to socioeconomic problems, the patient continued in 2023 with infiltration of the orbital cavity and paranasal sinuses with myiasis. Exenteration of the orbit can be necessary after a relapsed infiltrative type of basal cell carcinoma infiltrating also periorbital cavities. Fly maggots may have had beneficial but also destructive effects on the exenterated cavity healing process.