Eyelid Tumors - Symptoms, Diagnosis and Treatment

Eyelid Tumors

Dr.Santosh Honavar profile Authored by Dr.Santosh Honavar on 10 Jun 2015 - 13:45.

eyelid-tumorsThe eyelid skin is the thinnest and most sensitive skin. It is exposed to constant sun damage (UV radiation) and environmental toxins. Skin cancer of the eyelids is relatively common and can be of various types. Altered eyelid structure, presence of a nodule or lesion on the eyelid that grows, bleeds or ulcerates should be evaluated. 

Types of eyelid cancers:

  • Sebaceous cell carcinoma
  • Squamous cell carcinoma
  • Basal cell carcinoma
  • Malignant melanoma

Sebaceous cell carcinoma

Sebaceous cell carcinoma occurs in 60% of Asian Indian patients presenting with eyelid cancer. These tumors most commonly develop in upper eyelid followed by lower lid and inner corner of the eye. Origin can be from the Meibomian glands, glands of Zeis or the sebaceous glands of the caruncle. It is often diagnosed late and is missed because it simulates common benign conditions such as chalazion.  Any elderly individual with an eyelid nodule should seek opinion of an eye specialist.

Squamous cell carcinoma:

Squamous cell carcinoma accounts for around 20% of eyelid cancers in Asian Indians. It can appear as a flat, reddish or flaky lesion on the eyelid or may form an ulcerated nodule. It can spread to nearby lymph nodes and other parts of the body.

Basal cell carcinoma:

About 20 percent of all cancerous eyelid tumors in Asian Indians are basal cell carcinomas (BCCA). BCCA is a cancerous growth of the skin tissue that usually appears as a small, firm, raised pearly nodule with a lesion in the centre. The lower eyelids are involved in over 70% of cases, followed by inner corner of the eye, upper eyelid and the side corner of the eye. This type of cancer can cause significant damage to the affected area due to infiltration and it can recur in the same area or nearby areas, if it is not removed completely. However, these tumors generally do not spread to lymph nodes or other distant organs.

Malignant melanoma:

Melanoma of the eyelid is very uncommon and accounts for less than 1% of all eyelid cancers. Melanoma of the eyelid is similar to melanoma of the skin of the skin. It is staged and treated the same way as a skin melanoma.

 

 

 

The symptoms and signs of eyelid cancers are as follows:

  • Nodule or ulcer (area of skin breaks) noticed over eyelid skin
  • Pigmented (dark) lesion noticed on eyelid skin or margin
  • Repeated swellings of eyelids diagnosed as inflammation
  • Loss of eyelashes
  • Reddish discolouration of eyelid margin
  • Lymph node enlargement in the neck.

The diagnosis is based on complete clinical examination by the ophthalmologist. A biopsy of the mass or lesion might be required for confirmation of diagnosis.

The treatment plan includes surgery for complete excision of the tumor with a clear margin, followed by reconstruction of the lids. The reconstruction can be achieved by skin flaps from surrounding area or skin grafts from distant sites. A thorough histopathological examination is required of the resected tumor tissue to ensure complete excision. Chemotherapy and /or radiotherapy may be done for the residual tumor after surgery.

After completion of the treatment follow up is maintained, every three month for a year, every six monthly for a year and once a year, thereafter. 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.