[Characterization of periocular basal cell carcinoma in patients ≤ 50 years from 1996-2024 : A retrospective analysis at a university eye clinic].

Background: Basal cell carcinoma (BCC) is rare in patients ≤ 50 years and can be associated with tumor predisposition syndromes (TPDS). The BAP1-TPDS is particularly relevant for ophthalmologists as it is associated with other malignant nonocular tumors.

Objective: Retrospective analysis of patients ≤ 50 years with periocular BCC with respect to demographic, clinical and histological features for the identification of TPDS including BAP1 staining as a possible screening procedure for BAP1-TPDS.

Material and methods: Identification of all patients ≤ 50 years with histologically confirmed BCC surgically treated at this hospital in the period 1996-2024. Documentation of the localization and histological subtype as well as evaluation of the immunohistochemical BAP1 staining.

Results: During the observational period 38 patients ≤ 50 years with a BCC of the ocular adnexa were identified including 5 patients with multiple BCC. The average age of the patients at the time of excision was 42.7 years. The histological growth pattern was predominantly nodular (89%) and the localization of the tumors was in decreasing order the lower eyelid (53%), medial eyelid angle (26%) and upper eyelid (21%). Of the patients two had a TPDS (Gorlin-Goltz syndrome and xeroderma pigmentosum). The majority of the tumors examined showed a clear BAP1 staining reaction (89%), A proportion of positive tumor cells below 25% was present in only 4 patients.

Conclusion: In the case of patients ≤ 50 years with BCC or with other tumor entities, a TPDS should be considered. The BAP1 staining is interesting in this respect as it could represent an economically favorable screening method for a BAP1-TPDS and is possible without any substantial increase in labor costs.