Tratamiento quirúrgico y reconstrucción del cáncer periorbitario
DOI:
https://doi.org/10.29176/2590843X.257Palabras clave:
neoplasias, carcinoma, escamocelular, basocelular, melanoma, cirugía de MohsResumen
Introducción. Se ha estimado que, aproximadamente, 5 a 10 % de todos los cánceres de piel se ubican en la región periorbitaria. El párpado y, en general, la región periorbitaria son sitios anatómicos asociados a un gran riesgo de recurrencia y metástasis. Las recomendaciones sugieren practicar cirugía micrográfica de Mohs y escisión de segmentos por congelamiento.
Objetivo. Describir los antecedentes y el contexto actual del tratamiento quirúrgico y la reconstrucción para cáncer periorbital.
Métodos. Se hizo una búsqueda en la literatura científica, utilizando las palabras clave (MeSH): neoplasms, carcinoma, squamous cell, basosquamous, melanoma, Mohs surgery, y operadores booleanos. Las bases de datos donde se hizo la búsqueda fueron: Pubmed, Ebsco Host, Embase, Lilacs, Science direct y Ovid.
Conclusiones. La cirugía micrográfica de Mohs es actualmente la opción terapéutica y diagnóstica más completa y con menores tasas de recidiva para el tratamiento quirúrgico de tumores cutáneos complejos; además, permite ahorrar tejido sano con la seguridad de la erradicación tumoral. Se sugiere realizar estudios analíticos para establecer una mejor evidencia.
Biografía del autor/a
Miguel Olmos
Médico dermatólogo, cirujano dermatólogo, especialista en Cirugía de Mohs, Servicio de Dermatología, Hospital de San José, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia.
Nataly Portilla
Médica y cirujana; coordinadora médica, Clínica Erasmo, Valledupar, Colombia.
Carlos Castro
Médico epidemiólogo; instructor asociado, División de Investigaciones, Fundación Universitaria de Ciencias de la Salud, Bogotá, D.C., Colombia.
Referencias bibliográficas
1. Kikkawa D, Boddy S, Christine C. Reconstruction of large and complex periorbital defects from cutaneous cancer. International Ophtalmology Clinics. 2009;49:237-45.
2. Kummoona R. Periorbital and orbital malignancies: Methods of management and reconstruction in Iraq. J Craniofac Surg. 2007;18:1370-5.
3. Actis A, Actis G. Reconstruction of the upper eyelid with flaps and free grafts after excision of basal cell carcinoma. Case Rep Ophthalmol. 2011;2:347-53.
4. Moul CP, Peggy L, Peter R, Shumaker P, Daniel E, Hugh T. Mohs micrographic surgery for eyelid and periorbital skin cancer. International Ophthalmology Clinics. 2010;49:1536-9617.
5. Brian T, Lin J, Rubin P. Lateral canthal reconstruction after headneck or periocular cutaneous malignancy. International Ophthalmology Clinics. 2009;49:195-206.
6. Arquero P. Tratamiento reparador y reconstructor de las secuelas de la patología quirúrgica facial, 1998-2011. Fecha de consulta: Octubre-2012 Disponible en: http://www.clinicaarquero.com/10_ propedeutica10.htm.
7. Baker AI, Beas CK, Bloom BD. Colgajos locales en la reconstrucción facial. Philadelphia, editorial Mosby-Elsevier; 2010. Pág. 786
8. Cook B, Bartley G. Treatment options and future prospects for the management of eyelid malignancies. An Evidence-Based Update Ophthalmology. 2001;108:2088-98.
9. Mohs FE. Micrographic surgery for the microscopically controlled excision of eyelid cancers. Arch Ophthalmol. 1986;104:901-9.
10. Bernardini F. Management Of malignant and benign eyelid lesions. Curr Opin Ophthalmol. 2006;17:480-4.
11. Gilberg S, Tse D. Malignant eyelid tumors. Ophthalmol Clin North Am. 1992;5:261-85.
12. Khachemoune A, Suzanne M, Johnson D. Microcystic adnexal carcinoma: Report of four cases treated with Mohs’ micrographic surgical technique. Int J Dermatol. 2004;44:507-12.
13. Lindgren G, Lindblom B, Larko O. Mohs’ micrographic surgery for basal cell carcinomas on the eyelids and medial canthal area. Reconstruction and follow-up. Acta Ophthalmol Scand. 2000;78:1395-3907.
14. National Comprehensive Cancer Network. Guidelines index basal cell and squamous cell TOC staging, MS, Clinical Practice Guidelines in Oncology. Washigton. Clinical Practice Guidelines Ed.; 2012. Pág. 1-22.
15. Zaragosa P, Menéndez F, Gómez T. Carcinoma basocelular palpebral. Madrid, España, 2006. Fecha de consulta: Septiembre-2012. Disponible en: http://www.oftalmo.com/studium/studium2006/stud06-4/06d-03.htm.
16. Doxanas M, Green W, Iliff E. Factors in successful surgical management of basal cell carcinoma of the eyelids. Am J Ophthalmol. 1981;91:726-36.
17. Maloof A, Leatherbarrowe B. The maximal Hughes procedure. Ophtal Plast Reconstr Surg. 2001;17:96-102.
18. Margo E, Waltz K. Basal cell carcinoma of the eyelid and periocular skin. Surv Ophthalmol. 1993;38:169-92.
19. Wong V, Marshall A, Whitehead K. Management of periocular basal cell carcinoma with modified en face frozen section controlled excision. Ophthal Plast Reconstr Surg. 2002;18:430-5.
20. Reifler DM, Hornblass A. Squamous cell carcinoma of the eyelid. Surv Ophthalmol. 2004;30:349-65.
21. Leibovitch I, Huilgol C, Richards S. periorbital microcystic adnexal carcinoma: Management and outcome with Mohs Micrographic surgery. Ophthalmologica. 2006;220:109-13.
22. Nemet AY, Deckel Y, Martin PA. Management of periorbital basal and squamous cell carcinoma: A series of 485 cases. Am J Ophthalmol. 2006;142:293-7.
23. Peters GB MD, Shields JA. Management and prognosis of merkel cell carcinoma of the eyelid. Ophthalmology. 2001;108:1575-9.
24. Inkster C, Ashworth J, Murdoch JR. Oculoplastic reconstruction following Mohs surgery. Eye. 1998;12:214-8.
25. Kersten RC, Ewing-Chow D, Kulwin DR, Gallon M. Accuracy of clinical diagnosis of cutaneous eyelid lesions. Ophthalmology. 1997;104:479-84.
26. Lai M, Cheney ML. Temporoparietal fascial flap in orbital reconstruction. Arch Facial Plast Surg. 2000;2:196-201.
27. Weng C. Periorbital soft-tissue and socket reconstruction. Ann Plast Surg. 1995;34:457-62.
28. Bowman PH, Fosko SW, Hartstein ME. Periocular reconstruction. Semin Cutan Med Surg. 2003;22:263-72.
29. Harris GJ, Pérez N. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion. Ophthal Plast Reconstr Surg. 2003;19:5-13.
30. Patrinely JR, Marines HM, Anderson RL. Skin flaps in periorbital reconstruction. Surv Ophthalmol. 1987; 31 (4):249-61.
31. Kaufman AJ. Periorbital reconstruction with adjacent-tissue skin grafts. Dermatol Surg. 2005;31:1704-6.
32. Matsumoto K, Nakanishi H, Urano Y. Lower eyelid reconstruction with a cheek flap supported by fascia lata. Plast Reconstr Surg. 1999;103:1650-4.
33. Khan JA, Garden VS. Combined flap repair of moderate lower eyelid defects. Ophthal Plast Reconstr Surg. 2002;18:202-4.
34. Codner MA, Wolfli JN, Anzarut A. Primary transcutaneous lower blepharoplasty with routine lateral canthal support: A comprehensive 10-year review. Plast Reconstr Surg. 2008;121:241-50.
35. Zarem H, Resnick J. Expanded applications for transconjunctival lower lid blepharoplasty. Plast Reconstr Surg. 1999;88:215-20.
36. Patipa M. The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg.106:479-84.
37. Yanaga H, Mori S. Eyelids and eye socket reconstruction using the expanded forehead flap and scapha composite grafting. Plast Reconst Surg. 2001;108:8-16.
38. Scuderi N, Rubino C. Island chondro-mucosal flap and skin graft: A new technique in eyelid reconstruction. Br J Plast Surg. 1994;47:57-9.
39. Porfiris E, Georgiou P, Harkiolakis G. Island mucochondrocutaneous flap for reconstruction of total loss of the lower eyelid. Plast Reconstr Surg. 1997; 100 (1):104-7.
40. Lagares A, De lope F, Góngora J, Barrera F, Gómez T. Reconstrucción de párpado inferior mediante colgajos miocutáneos en isla de los músculos orbicular y nasal. Cir Plást Iberolatinoam. 2009;35:35-42.
41. Callahan MA, Callahan A. Mustarde flap lower lid reconstruction after malignancy. Ophthalmology. 1980;87:279-86.
42. Shields JA, Demirci H MB. Sebaceous carcinoma of the eyelids: Personal experience with 60 cases. Ophthalmology. 2004;111:2151-7.
43. Harris G, Logani SC. Multiple aesthetic unit flaps for medial canthal reconstruction. Ophthal Plast Reconstr Surg. 1998;14:352-9.
44. Jelks GW, Glat P, Jelks EB, Longaker M. Medial canthal reconstruction using a medially based upper eyelid myocutaneous flap. Plast Recontr Surg. 2002;110:1636-43.
45. Suárez R, Valdivieso M, Martínez D, Mauleón C, Colgajos cutáneos –los más usados. Cirugía Dermatológica. 2001;4:319-25.
46. Vayvada H, Menderes A, Tan Ö, Yilmaz M. Total lower eyelid reconstruction using paranasal flap. J Craniofac Surg. 2006;17(5):1020-6.
47. Jones IS, Cooper WC. Lateral canthal reconstruction. Trans Am Ophthalmol Soc. 1973;71:296-302.
48. Jelks G, Glat P, Jelks B, Longaker T. The inferior retinacular lateral canthoplasty: A new technique. Plast Reconstr Surg. 1997;100:1262-70.
49. Glat P, Jelks G. Evolution of lateral canthoplasty: Techniques and indications. Plast Reconstr Surg. 1997;100:1396-414.
50. Cologlu H, Kocer U, Oruc M. Axial bilobed superficial temporal artery island flap (tulip flap): Reconstruction of combined defects of the lateral canthus including the lower and upper eyelids. Plast Reconstr Surg. 2007;119:2080-7.
51. Leone CR. Lateral canthal reconstruction. Ophthalmology. 1987;94:238-41.
2. Kummoona R. Periorbital and orbital malignancies: Methods of management and reconstruction in Iraq. J Craniofac Surg. 2007;18:1370-5.
3. Actis A, Actis G. Reconstruction of the upper eyelid with flaps and free grafts after excision of basal cell carcinoma. Case Rep Ophthalmol. 2011;2:347-53.
4. Moul CP, Peggy L, Peter R, Shumaker P, Daniel E, Hugh T. Mohs micrographic surgery for eyelid and periorbital skin cancer. International Ophthalmology Clinics. 2010;49:1536-9617.
5. Brian T, Lin J, Rubin P. Lateral canthal reconstruction after headneck or periocular cutaneous malignancy. International Ophthalmology Clinics. 2009;49:195-206.
6. Arquero P. Tratamiento reparador y reconstructor de las secuelas de la patología quirúrgica facial, 1998-2011. Fecha de consulta: Octubre-2012 Disponible en: http://www.clinicaarquero.com/10_ propedeutica10.htm.
7. Baker AI, Beas CK, Bloom BD. Colgajos locales en la reconstrucción facial. Philadelphia, editorial Mosby-Elsevier; 2010. Pág. 786
8. Cook B, Bartley G. Treatment options and future prospects for the management of eyelid malignancies. An Evidence-Based Update Ophthalmology. 2001;108:2088-98.
9. Mohs FE. Micrographic surgery for the microscopically controlled excision of eyelid cancers. Arch Ophthalmol. 1986;104:901-9.
10. Bernardini F. Management Of malignant and benign eyelid lesions. Curr Opin Ophthalmol. 2006;17:480-4.
11. Gilberg S, Tse D. Malignant eyelid tumors. Ophthalmol Clin North Am. 1992;5:261-85.
12. Khachemoune A, Suzanne M, Johnson D. Microcystic adnexal carcinoma: Report of four cases treated with Mohs’ micrographic surgical technique. Int J Dermatol. 2004;44:507-12.
13. Lindgren G, Lindblom B, Larko O. Mohs’ micrographic surgery for basal cell carcinomas on the eyelids and medial canthal area. Reconstruction and follow-up. Acta Ophthalmol Scand. 2000;78:1395-3907.
14. National Comprehensive Cancer Network. Guidelines index basal cell and squamous cell TOC staging, MS, Clinical Practice Guidelines in Oncology. Washigton. Clinical Practice Guidelines Ed.; 2012. Pág. 1-22.
15. Zaragosa P, Menéndez F, Gómez T. Carcinoma basocelular palpebral. Madrid, España, 2006. Fecha de consulta: Septiembre-2012. Disponible en: http://www.oftalmo.com/studium/studium2006/stud06-4/06d-03.htm.
16. Doxanas M, Green W, Iliff E. Factors in successful surgical management of basal cell carcinoma of the eyelids. Am J Ophthalmol. 1981;91:726-36.
17. Maloof A, Leatherbarrowe B. The maximal Hughes procedure. Ophtal Plast Reconstr Surg. 2001;17:96-102.
18. Margo E, Waltz K. Basal cell carcinoma of the eyelid and periocular skin. Surv Ophthalmol. 1993;38:169-92.
19. Wong V, Marshall A, Whitehead K. Management of periocular basal cell carcinoma with modified en face frozen section controlled excision. Ophthal Plast Reconstr Surg. 2002;18:430-5.
20. Reifler DM, Hornblass A. Squamous cell carcinoma of the eyelid. Surv Ophthalmol. 2004;30:349-65.
21. Leibovitch I, Huilgol C, Richards S. periorbital microcystic adnexal carcinoma: Management and outcome with Mohs Micrographic surgery. Ophthalmologica. 2006;220:109-13.
22. Nemet AY, Deckel Y, Martin PA. Management of periorbital basal and squamous cell carcinoma: A series of 485 cases. Am J Ophthalmol. 2006;142:293-7.
23. Peters GB MD, Shields JA. Management and prognosis of merkel cell carcinoma of the eyelid. Ophthalmology. 2001;108:1575-9.
24. Inkster C, Ashworth J, Murdoch JR. Oculoplastic reconstruction following Mohs surgery. Eye. 1998;12:214-8.
25. Kersten RC, Ewing-Chow D, Kulwin DR, Gallon M. Accuracy of clinical diagnosis of cutaneous eyelid lesions. Ophthalmology. 1997;104:479-84.
26. Lai M, Cheney ML. Temporoparietal fascial flap in orbital reconstruction. Arch Facial Plast Surg. 2000;2:196-201.
27. Weng C. Periorbital soft-tissue and socket reconstruction. Ann Plast Surg. 1995;34:457-62.
28. Bowman PH, Fosko SW, Hartstein ME. Periocular reconstruction. Semin Cutan Med Surg. 2003;22:263-72.
29. Harris GJ, Pérez N. Anchored flaps in post-Mohs reconstruction of the lower eyelid, cheek, and lateral canthus: avoiding eyelid distortion. Ophthal Plast Reconstr Surg. 2003;19:5-13.
30. Patrinely JR, Marines HM, Anderson RL. Skin flaps in periorbital reconstruction. Surv Ophthalmol. 1987; 31 (4):249-61.
31. Kaufman AJ. Periorbital reconstruction with adjacent-tissue skin grafts. Dermatol Surg. 2005;31:1704-6.
32. Matsumoto K, Nakanishi H, Urano Y. Lower eyelid reconstruction with a cheek flap supported by fascia lata. Plast Reconstr Surg. 1999;103:1650-4.
33. Khan JA, Garden VS. Combined flap repair of moderate lower eyelid defects. Ophthal Plast Reconstr Surg. 2002;18:202-4.
34. Codner MA, Wolfli JN, Anzarut A. Primary transcutaneous lower blepharoplasty with routine lateral canthal support: A comprehensive 10-year review. Plast Reconstr Surg. 2008;121:241-50.
35. Zarem H, Resnick J. Expanded applications for transconjunctival lower lid blepharoplasty. Plast Reconstr Surg. 1999;88:215-20.
36. Patipa M. The evaluation and management of lower eyelid retraction following cosmetic surgery. Plast Reconstr Surg.106:479-84.
37. Yanaga H, Mori S. Eyelids and eye socket reconstruction using the expanded forehead flap and scapha composite grafting. Plast Reconst Surg. 2001;108:8-16.
38. Scuderi N, Rubino C. Island chondro-mucosal flap and skin graft: A new technique in eyelid reconstruction. Br J Plast Surg. 1994;47:57-9.
39. Porfiris E, Georgiou P, Harkiolakis G. Island mucochondrocutaneous flap for reconstruction of total loss of the lower eyelid. Plast Reconstr Surg. 1997; 100 (1):104-7.
40. Lagares A, De lope F, Góngora J, Barrera F, Gómez T. Reconstrucción de párpado inferior mediante colgajos miocutáneos en isla de los músculos orbicular y nasal. Cir Plást Iberolatinoam. 2009;35:35-42.
41. Callahan MA, Callahan A. Mustarde flap lower lid reconstruction after malignancy. Ophthalmology. 1980;87:279-86.
42. Shields JA, Demirci H MB. Sebaceous carcinoma of the eyelids: Personal experience with 60 cases. Ophthalmology. 2004;111:2151-7.
43. Harris G, Logani SC. Multiple aesthetic unit flaps for medial canthal reconstruction. Ophthal Plast Reconstr Surg. 1998;14:352-9.
44. Jelks GW, Glat P, Jelks EB, Longaker M. Medial canthal reconstruction using a medially based upper eyelid myocutaneous flap. Plast Recontr Surg. 2002;110:1636-43.
45. Suárez R, Valdivieso M, Martínez D, Mauleón C, Colgajos cutáneos –los más usados. Cirugía Dermatológica. 2001;4:319-25.
46. Vayvada H, Menderes A, Tan Ö, Yilmaz M. Total lower eyelid reconstruction using paranasal flap. J Craniofac Surg. 2006;17(5):1020-6.
47. Jones IS, Cooper WC. Lateral canthal reconstruction. Trans Am Ophthalmol Soc. 1973;71:296-302.
48. Jelks G, Glat P, Jelks B, Longaker T. The inferior retinacular lateral canthoplasty: A new technique. Plast Reconstr Surg. 1997;100:1262-70.
49. Glat P, Jelks G. Evolution of lateral canthoplasty: Techniques and indications. Plast Reconstr Surg. 1997;100:1396-414.
50. Cologlu H, Kocer U, Oruc M. Axial bilobed superficial temporal artery island flap (tulip flap): Reconstruction of combined defects of the lateral canthus including the lower and upper eyelids. Plast Reconstr Surg. 2007;119:2080-7.
51. Leone CR. Lateral canthal reconstruction. Ophthalmology. 1987;94:238-41.
Cómo citar
1.
Olmos M, Portilla N, Castro C. Tratamiento quirúrgico y reconstrucción del cáncer periorbitario. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de julio de 2013 [citado 18 de abril de 2024];21(3):226-38. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/257
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2013-07-01
Cómo citar
1.
Olmos M, Portilla N, Castro C. Tratamiento quirúrgico y reconstrucción del cáncer periorbitario. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 1 de julio de 2013 [citado 18 de abril de 2024];21(3):226-38. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/257
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