Eyelid Skin Cancers

By Balaji Perumal, M.D.

About Eyelid Skin Cancers
Eyelid Skin Cancers are becoming more and more common as people live active outdoor lifestyles and simply live longer today. Growths around the eyelids and face are common. As part of your regular eye exam at D'Ambrosio Eye Care we take the time to carefully evaluate the skin around your eyes and your eyelids as your eye health and vision are our #1 priority. Fortunately, although growths on the eyelids and surrounding skin are common, the vast majority of these lesions are benign and can be easily removed right in the office. Our approach to growths on the eyelids and face is similar what you might have been told or experienced regarding skin growths elsewhere on your body.
That is……..

CHANGES IN APPEARANCE, SIZE OR COLOR OF GROWTHS ON THE SKIN OF YOUR EYELIDS OR FACE SHOULD BE REPORTED TO YOUR EYE DOCTOR

Sometimes, a biopsy may be required. This procedure is quick, relatively simple and not uncomfortable. Our doctors have many years of experience in evaluating and treating all forms of abnormal growths of the face and eyelids. Should a biopsy determine that the growth in question is malignant we will take the time necessary to fully explain your treatment options and help you make the best decision for your care. There are several more common types of malignant growths of the eyelid and face that we typically look for. These include:

Basal Cell Carcinoma
Basal Cell Carcinoma is by far, the most common malignant or cancerous growth of the eyelid. For the most part, this is a very slow growing malignancy that may be present for several months before it is recognized. This type of eyelid or skin cancer rarely spreads to other parts of the body, but it does require removal. In general, we will perform an evaluation of any abnormal growth of the face and eyelids and will may recommend an in office biopsy. The biopsy will be read and interpreted by a pathologist. Should the pathologist determine that it is positive for malignancy, it is likely that further management will be required. This may include a simple office procedure or may require extensive removal and reconstruction in an operating room setting, often under anesthesia. If this is done in the hospital, frozen sections will be taken of the margins of the lesion. These specimens will be sent to the pathologist while your doctor awaits the report. When all abnormal tissue has been removed, the doctor will reconstruct the affected area. This may require simple closure with sutures, or it may require the use of skin grafts or flaps.

Once the tumor is removed completely, IT IS IMPORTANT that we keep you under observation yearly over the next several years. It is unlikely that the tumor will recur or cause further problems, but once you have a single basal cell, it is certainly more likely to have others in the coming years. Generally, patients do extremely well and most patients who undergo resection and reconstruction of a Basal Cell Carcinoma can have no residual cosmetic deformity.

Squamous Cell Carcinoma
Squamous Cell Carcinoma is also a relatively slow growing eyelid or skin cancer. It does however, have a greater potential to invade the surrounding tissue, as well as metastasize and spread. It can also travel along nerve roots and therefore, can often cause pain. Fortunately, it is much less common than Basal Cell Cancers. Squamous Cell Carcinoma is treated much in the same way as Basal Cell Cancer, although it can require a wider excision. Most often we deal with Squamous Cell Carcinoma much more promptly than a Basal Cell Cancer.

Sebaceous Cell Adenocarcinoma
Sebaceous Cell Adenocarcinoma is extremely rare, but it is very specific to the eyelids. It can clinically mimic several other benign problems of the eye and it is therefore misdiagnosed or diagnosed after some time delay. It most frequently occurs in patients in their 70's and 80's but can occur at any age. It is serious in the sense that it has metastatic potential and is often likely to spread. Diagnosis can be difficult even when an adequate biopsy specimen is obtained and sent for pathologic evaluation.

Melanoma
Like other parts of the body, an abnormal coloration to the skin can represent a Melanoma or something along the spectrum of a Melanoma. While eyelid or facial melanomas are rare, any pigmented lesion around the eyelid deserves our attention. The guidelines for attention to abnormal coloration of the skin on the eyelids or face are similar to the guidelines for pigmented lesions or moles on other parts of the body.

Changes in Color, Size or Behavior All Warrant Our Evaluation & Possible Biopsy.

 

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