[Orbital exenteration. A preventable course in tumor treatment?!]

We reviewed the conditions leading to the mutilating procedure of orbital exenteration in 24 patients at our institution between 1980 and 1993. In 17 cases, including 16 of 17 patients with malignant tumours of the eyelid, this operation could potentially have been avoided. Three of these 17 patients first saw a doctor at an extremely advanced and otherwise untreatable stage of the tumour. The other 14 patients had at least one previous treatment attempt. Six patients with basal cell carcinoma had been primarily treated with radiation alone; two of them developed a squamous cell carcinoma subsequently. In six cases primary reconstruction was performed despite incomplete resection. In one patient a meibomian gland carcinoma was misdiagnosed as a chalazion and excised without histological examination. In another case of squamous cell carcinoma a cutaneous incisional biopsy 6 months prior to orbital exenteration revealed a papilloma. These results emphasize the necessity of careful histological examination in the treatment of lid tumours.