Eyelid tumors are not uncommon and can be benign or malignant. The most common malignant eyelid tumors include basal cell carcinoma, sebaceous gland carcinoma, squamous cell carcinoma, and malignant melanoma. Skin cancer often involves the skin of the eyelid (most commonly the lower eyelid) or adjacent face; however, it may be found anywhere on the eyelid margins, corners of the eye, eyebrow skin, or adjacent areas of the face.

Basal Cell Carcinoma

Basal cell carcinoma, the most common eyelid malignancy, accounting for over ninety percent of all cancerous lid lesions. Lesions usually appear in the lower lid and medial canthal region as a firm, pearly nodule.

Basal cell carcinoma is a type of skin cancer that affects the skin’s basal layer, the 5th layer of skin and invades areas under the skin. This condition does not become life-threatening unless it is ignored entirely. Lesion sizes vary from small to large (if left untreated).

The basal cell lesion appear in one of three ways:

• The nodular form appears as a small, translucent, raised area with poorly defined edges, and is firm to the touch
• The classic ulcerative presentation is a nodular lesion that over time has developed telangiectasia (a reddish hue caused by persistent, and virtually permanent, dilation of capillaries) along the surface and an atrophied inner portion, creating a “pearly,” indurated outer margin with an excavated center
• Less frequently, the sclerosing or morpheaform basal cell carcinoma form, which has a firm, pale, waxy yellow plaque with indistinct borders.

Causes

This disorder is caused by increasing age and by life-long exposure to the sun. The progression of this tumor is usually exceedingly slow. If left untreated the lesion may in time develop into a open sore and invade deeper structures. Fortunately, metastasis is rare, and complete recovery is possible with proper therapy.

Treatment

The treatment options for eyelid tumors vary according to the tumor and include observation, incisional biopsy, excisional biospy, eyelid reconstruction, radiotherapy, chemotherapy, and exenteration.

The growth can also be removed by:

• Cryosurgery – destruction of abnormal tissue using freezing temperatures. Usually with liquid nitrogen.
• Electrosurgery – destruction of abnormal tissue with the application of heat. Usually an electric cautery source.

Dr. Gary A. Passons, M.D.