Orbito-scleral-sinus invasion of basal cell carcinoma in an immunocompromised patient on vismodegib

Ann Q. Tran, Carissa L. Patete, Nathan W. Blessing, Andrew J. Rong, Armando L. Garcia, Sander Dubovy, David T. Tse

Research output: Contribution to journalArticlepeer-review

Abstract

A 45-year-old man presented with a progressively enlarging left lower lateral eyelid lesion. The initial biopsy was inconclusive; however, a repeat biopsy 5 years later revealed infiltrative morpheaform basal cell carcinoma with sclerosis. Two years later, the patient presented with ophthalmoplegia of the left eye. Computed tomography illustrated a heterogeneous enhancing soft tissue mass in the inferolateral orbit with erosion into the globe. Despite treatment with vismodegib for 1 year, the lesion progressed to involve the entire left lower eyelid and corneal-scleral junction with adjacent maxillary sinus invasion. The patient tested positive for human immunodeficiency virus and underwent a left orbital exenteration followed by adjuvant radiotherapy. The patient remained stable with no evidence of recurrent disease or distant metastasis 2 years after exenteration. This rare case highlights a neglected basal cell carcinoma in those immunocompromised with histopathological correlation of the aggressive disease on to the globe.

Original languageEnglish (US)
JournalOrbit (London)
DOIs
StateAccepted/In press - 2020

Keywords

  • Basal cell carcinoma
  • basal cell carcinoma of the eyelid
  • human immunodeficiency virus
  • orbital malignancy
  • vismodegib

ASJC Scopus subject areas

  • Ophthalmology

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