Implantation Irradiation of Epitheliomata of the Eyelids and Adjacent Areas.

As far as is known the first description of a rodent ulcer was given by Jacobt(1827), who stated: "The characteristic features of this disease are the slowness of its progress, the peculiar condition of the edges and surface of the ulcer, and the comparatively inconsiderable suffering produced by it, its incurable nature except by extirpation, and it not contaminating the neighbouring lymphatic glands". Apart from Jacob's comment that extirpation is the only cure, which fortunately no longer holds true, this description of a rodent ulcer remains accurate. It is now seldom the lot of the ophthalmic surgeon to treat lesions as gross as that illustrated by Jacob, but he frequently has to deal with the condition in an early stage. The guiding principles for the modern therapeutic approach to malignant lesions of the eyelids are to obtain complete obliteration of the growth and to insure against recurrence while maintaining full function of the eye and its adnexa with the best possible cosmetic result. The accepted methods of treatment are surgical removal, radiotherapy, or a combination of the two. To achieve the major aim of complete cure by excision, the amount of clearance may have to be quite extensive, and much re-constructive surgery is often required to obtain full function and good appearance. The following series of eighteen cases is designed to demonstrate the effectiveness with which implanted radiation material will deal with basal cell or squamous epitheliomata on the eyelids or in the region surrounding the orbit without causing gross functional impairment or disfigurement.