Baltimore Washington Eye Center, Maryland

Tuesday, November 29, 2011

Malignant Eyelid Lumps and Bumps-What are They?

Here are definitions/descriptions of some of the most common eyelid cancers
·         Basal Cell Carcinoma-This is the most common skin cancer found on the eyelid. It is seen most often in people with fair skin who have a history of significant sun exposure.  It can occur on the upper or lower eyelid. Basal cell lesions usually appear relatively well defined, often with pearly edges and small blood vessels overlying it. Sometimes, depending on the location of the lesion, people will notice a loss in lashes in the same area. Most of the time, this is a very slow growing malignancy that is present for months before it is recognized. It rarely spreads to other parts of the body, but it does require removal and biopsy.  The extent of the tumor may be larger than it appears on the surface and a biopsy allows the pathologist to look for abnormal cells at a microscopic level so ensure that the tumor has been completely resected.

·         Squamous Cell Carcinoma-This is the second most common type of eyelid skin cancer. It is also found more often in patients with fair skin and a history of sun exposure and is usually found on the lower lid, but can occur on the upper.  Fortunately, it is a relatively slow growing cancer. It does, however, have the potential to invade the surrounding tissue, as well as metastasize and spread.  Squamous cell lesions appear flat or slightly elevated and are red and scaly; sometimes early lesions can present like a papilloma. The treatment is surgical, but this cancer often has microscopic spread, so the excision can be wider than with basal cell and often is done in collaboration with a dermatologist specializing in this type of surgery.

·         Melanoma-This is a rare form of eyelid skin cancer. The lesions are often tan, black or gray with irregular edges and can be rapidly growing. It is the most lethal of the skin cancers, but fortunately, it is rare, accounting for <1% of all eyelid cancers. The prognosis depends on the size of the lesion, the depth of growth, and the microscopic cell type.  Treatment is excision and biopsy and dermatologic evaluation for lesions elsewhere on the body.

Guest Blogger: D. Chimene Richa, M.D. Oculofacial Surgeon with the Baltimore Washington Eye Center