Purpose

To report a case of Recurrent Eyelid Basal-cell Carcinoma in a patient managed at a tertiary government hospital in the Philippines.

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Methods

This case report describes the clinical evaluation and management of a female presenting with a recurrent left medial canthal mass 2 years after prior excision. Initial assessment included detailed external ocular examination to document lesion extent and associated eyelid abnormalities, followed by orbital computed tomography to assess soft tissue, orbital, or bony involvement. The patient underwent wide local excision with 3 mm margins and full-thickness eyelid reconstruction using an advancement flap and preauricular skin graft, with lateral canthotomy and cantholysis for defect mobilization. The excised specimen was submitted for histopathologic analysis with margin assessment. Postoperative surveillance included serial clinical examinations and CT of the neck and chest at 3 months.

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Results

Histopathologic examination confirmed nodulocystic and adenoid basal cell carcinoma measuring 2.6 cm, confined to the reticular dermis, with negative surgical margins and no lymphovascular or perineural invasion. At 3-month follow-up, CT of the neck and chest showed stable postoperative soft tissue changes without regional or distant metastasis. The reconstructed eyelid remained intact, and the patient was maintained on topical lubrication, wound care, and close surveillance, with referral to Oncology for adjuvant radiotherapy.

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Conclusion

Eyelid basal cell carcinoma, particularly at the medial canthus, carries a meaningful risk of recurrence despite its favorable prognosis. Durable tumor control depends on early recognition, accurate histopathologic confirmation, and complete margin-controlled excision with appropriate eyelid reconstruction. Because most recurrences arise within 3 to 5 years, especially in previously operated medial canthal lesions, vigilant long-term postoperative surveillance is essential, with adjuvant radiotherapy considered in selected recurrent or infiltrative cases to optimize oncologic and functional outcomes.

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Additional Authors

First name	Last name	Base Hospital / Institution
Mariel Angelou A.	Parulan	Quirino Memorial Medical Center

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