Lamberto A. Ilagan Jr.
Our Lady of Caysasay Medical Center, Lemery Batangas, Philippines
Title: Destructive Orbital Myiasis in a Case of Basal Cell Carcinoma
Biography
Biography: Lamberto A. Ilagan Jr.
Abstract
This is a case report of an 80 year old female presented with a bleeding hyperpigmented mass over the left upper eyelid. Gradual increase in the size has been observed over 4 years. Prior consult at a tertiary hospital and incision biopsy revealed carcinoma. She was advised surgery but refused and was lost to follow-up. On examination a 5 x 4mm hyperpigmented ulcerated mass was seen on the lateral aspect of the left upper lid. Upon removal of the superficial crust, multiple live maggots were seen swarming within the ulcerated lesion. Impression was Orbital Myasis, left t/c Basal Cell Carcinoma. Intravenous Ampicillin- Sulbactam 250mg/IV every 8 hours and IV Ketorolac 30mg/IV every 8 hours and a single dose of Mebendazole 500mg/tab were given. Orbital MRI was advised however patient refused due to lack of funding. She underwent debridement and biopsy of the lesion with manual extraction of the maggots. Xylocaine spray was observed to immobilize the larvae. Vaselinized (Petroleum Jelly) gauze was placed over the lesion in order for the larvae in deeper tissues to come out. Histopathology confirmed Basal Cell Carcinoma. Orbital Myasis is a rare condition that causes massive tissue destruction and orbital inflammation. Management options consist of mechanical removal of the larvae, antihelminthic therapy, surgical debridement and orbital exentration for extensive lesions