Resection of bilateral orbital and cranial base basal cell carcinoma with preservation of vision.

Abstract

The surgical resection of skull base tumors often presents technically challenging problems and can result in major deformities. In planning the operation, each individual patient must be evaluated not only with respect to the extent of the disease, but also with respect to the functional losses, which may severely affect the patient's quality of life. The patient presented is an elderly woman with a malignant anterior skull base basal cell carcinoma and multiple recurrences. The tumor extended to the orbits bilaterally, resulting in blindness in the right eye. The objective was to resect the tumor from the skull base and the orbits, while preserving vision in the left eye. Utilizing intraoperative frozen sections, extensive tumor resection in the left orbit was accomplished without compromising vision. This was followed by the reconstruction of the eyelids and periorbital tissues. Exenteration of the right orbit, anterior craniectomy, and partial dural resection were also performed. Ten years later, the patient remains free of tumor recurrence and has good vision in her left eye.