EYELID TUMOR SURGERY
- Eyelid Lesions can be benign or malignant
- The 2nd most common facial location for skin cancer is the eyelids
- For malignant lesions, Moh’s surgery followed by reconstructive surgery is typically the treatment of choice
- Most eyelid lesions require a biopsy to determine if they are malignant
Skin cancer is becoming more common as we develop better diagnostic techniques, as our population ages and as sun exposure increases. Skin cancer often involves the skin of the eyelid or adjacent face. Indeed, sun exposed areas of the body are more commonly affected by skin cancer. They usually appear as painless lesions or nodules. There may be loss of eyelashes, ulceration of the skin, bleeding and distortion of the normal structure of the eyelids. When these findings are noted, they need to be evaluated and may require a biopsy to confirm the diagnosis.
The most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. In general, these are painless elevated nodules that enlarge locally and rarely spread (metastasize) to different parts of the body. If not treated promptly, these lesions can enlarge to involve adjacent structures including the eye. There are several ways to treat these lesions including cryotherapy (freezing), topical chemotherapeutic agents, and surgery. Complete excision (with the aid of frozen sections or Moh’s surgery) of the lesion has been shown to be the most effective method of treatment. Once the lesion is excised completely, the resultant defect can be reconstructed with various reconstructive techniques.
Sebaceous gland carcinoma and malignant melanoma are more rare than the above tumors and more serious forms of skin cancer. These tumors not uncommonly spread to adjacent and distant parts of the body. When these diagnoses are made, prompt aggressive treatment is required because of the threat of early spread.
Preoperative Evaluation of patients with eyelid lesions is much the same as patients with eyelid deformities. When a malignancy is suspected however, evaluation of regional lymph nodes and/or possible metastasis (spread to distant sites) may be performed.
As with the treatment of any other eyelid abnormality it is imperative that all patients have a thorough examination of their eye. This starts with a measurement of the visual acuity. A complete examination of the ocular surface, tear film and contents of the eye is performed. Occasionally, eyelid cancer can occur in systemic illness which must be addressed.
© 2020 GRANT GILLILAND MD. All Rights Reserved.