By Paul T. Finger, MD
Tumors of the eyelids may be benign cysts, inflammations (styes), or malignant tumors (skin cancers). The most common type of eyelid cancer is basal cell carcinoma. Most basal cell carcinomas can be removed with surgery. If left untreated, these tumors can grow around the eye and into the orbit, sinuses and brain. Other eyelid cancers include squamous cell carcinoma, sebaceous cell carcinoma, and malignant melanoma. Together, these tumors make up the remaining 10% of eyelid malignancies.
Most patients with eyelid tumors will notice a nodular growth on their eyelid. This growth can be skin colored, red, brown or black. Malignant tumors may cause loss of eyelashes or distort the position of the eyelid. All patients with eyelid tumors should be evaluated by an eye care specialist with experience in the care of eyelid tumors.
A simple biopsy can determine if an eyelid tumor is malignant.
Malignant tumors are completely removed and the eyelid is repaired using plastic surgery techniques. Some doctors are now using topical immunotherapy or chemotherapy agents to avoid surgery. Dr. Finger can sometime use “Finger-tip” cryotherapy (freezing-therapy) or radiation therapy, depending on the extent of the tumor.
A Typical Work-up for a Suspected Malignant Eyelid Tumor:
- Medical Work-up (as indicated)
- Treatment (surgery, chemotherapy, immunotherapy, cryotherapy)
- Reconstruction as needed
Surgery for Eyelid Tumors:
- General: The goal should be total removal of the eyelid cancer. This usually involves primary excision with either frozen section control or the Moh’s technique.
- Small tumors are usually removed by pentagonal wedge resection.
- Medium-sized tumors often require reconstruction with transpositional flaps (Tenzel, Mustarde, Glabellar).
- Large-tumor resections are typically reconstructed with Hughes, Hewes or Cutler-Beard Techniques.