Periocular metatypical cell carcinoma: clinicopathologic correlation, management, and follow-up in 35 patients.

Background: To present the clinical characteristics and treatment outcomes in a relatively large series of patients with periocular metatypical cell carcinoma.

Methods: This is a retrospective study of 35 patients with periocular metatypical cell carcinoma, who were seen between January 2000 and December 2004 in Izmir Ataturk Research and Training Hospital, Turkey. The patients were histologically confirmed metatypical cell carcinoma with radiologic evidence of periocular region. The main outcome measures were patients' demographics, duration of tumour, clinical presentation, tumour site, treatment modalities, recurrence rate and tumour-related exenteration. Statistical comparisons between the nonrecurring group and recurring group were completed using the Cox regression analysis and the log rank test. Significance was determined for all statistical tests as pé 0.05.

Results: The median age of patients at time of diagnosis was 61 years. The most common site for metatypical cell carcinoma was medial canthus and lower eyelid region. The median follow-up for all patients was 18 months. The average length of time until recurrence was 13 months. Five of the 35 patients received adjuvant therapy to the primary tumour site after excision. Signs suggestive of orbital involvement included bone fixation of the mass, limitation of ocular motility and globe displacement. The early lack of diagnostic criteria for metatypical cell carcinoma created considerable debate and confusion regarding its diagnosis. We believe that once this diagnosis is made, the treatment modality should be individualized and chosen with consideration of the extent of orbital involvement, visual function, and the patient's general health.