There are a variety of tumors that may be benign or malignant, and treatment depends on the cause. Special care is necessary to avoid ocular complications that could compromise vision, comfort, and cosmesis.
Benign Eyelid Tumors
Benign eyelid lesions include a diverse group of tumors, infections, and degenerative lesions that require specialized care of identification and treatment. Lesions in this category include the stye (chalazion), inclusion cyst, sweat gland cyst, keratosis, nevus (mole), wart, and skin tag. Diagnosis of benign eyelid lesions is based on their clinical characteristics, but occasionally, a biopsy may be indicated. Treatment of these lesions may include simple observation, medication, surgery, and laser surgery. Improvement or complete resolution of these eyelid lesions is possible, but recurrence of the lesions is common.
Malignant Eyelid Tumors
The eyelid skin is the thinnest and most sensitive skin on your body. As a result, this is often the first area on your face to show change from sun damage and aging. Unfortunately, sun damage and other environmental toxins not only cause the skin to age but can cause serious damage. Skin cancer of the eyelids is relatively common and several types exist, with BCC, SCC and Melanoma being the most common. The presence of a nodule or lesion on the eyelid that grows, bleed or ulcerates should be evaluated. This involves examination and sometimes a biopsy.
Basal Cell Carcinoma
Basal cell tumors represent the ninety percent of eyelid tumors. These skin cancers grow slowly over months and years. They most often appear as a pearly nodule that eventually starts to break down and ulcerate. Despite being a cancer, these tumors don’t spread to distant areas but rather just continue to grow and infiltrate the surrounding tissue. They typically can be removed by excision followed by reconstruction of the defect left behind after the tumor removal.
Squamous Cell Carcinoma, Melanoma, and Sebaceous Carcinoma
These types of tumors occur much less common but are more aggressive and require more involved care to ensure complete treatment. Again, primary treatment involves removing the tumor, but care must also be taken to ensure the tumor has not spread anywhere, causing larger health problems. Your surgeon will help coordinate this part of your treatment depending on the size and circumstances of the tumor at presentation.
Skin cancer needs to be removed surgically by a skilled individual who can not only remove the tumor but reconstruct the eyelid or area where the tumor was removed. Sometimes the ophthalmic plasatic surgeon will do this process at a surgical facility with an onsite pathologist who can immediately examine the specimen to ensure the whole tumor was removed. Other times, the help of a dermatologic surgeon specializing in Mohs surgical excision will be utilized. This procedure is completed into two steps, the first in the dermatologist’s office with immediate examination of the tumor to ensure its complete removal followed by the reconstructive surgery by your surgeon. Ophthalmic plastic surgeons are the optimal person to repair these defects as the eyelid anatomy is quite delicate and complex.