Tumors are abnormal growths of tissue that can be benign or malignant. Any tumors that form on the eyelid should be evaluated and treated as quickly as possible, and cancerous tumors typically require immediate medical attention. Even a benign tumor can cause pain or damage to the eye, such as blocking the tear ducts or preventing the eyelids from closing. A biopsy will usually determine whether the eyelid tumor is benign or malignant.
The skin of the eyelid is particularly susceptible to damage due to sun exposure and other factors, and this may lead to the formation of a tumor. If an existing mole or lesion increases in size, begins to bleed or changes in any noticeable way, it is important that it be examined by a doctor right away.
Cancers of the Eyelid
Skin cancers of the eyelid often involve the lower lid, as well as the eyelid margins, the corners of the eye, the skin around and beneath the eyebrows and areas of the face near the eye. Whether the skin cancer is slow or fast to progress, it needs to be removed as soon as possible to minimize the chance of it spreading to other parts of the body or of recurring in the future.
Basal Cell Carcinoma
Approximately 90 percent of cancers of the eyelid are basal cell carcinomas. They are malignant but rarely metastasize to other parts of the body. Typically very slow growing tumors, basal cell carcinomas are usually small, firm nodules with a shiny appearance that tend to form on the lower eyelids, in the corner of the eye or on the upper eyelid. Over time, the tissue of the tumor may start to decay and affect the surrounding skin or structures of the eye.
Squamous Cell Carcinoma
Squamous cell carcinoma is a much less common form of eyelid cancer, responsible for approximately 5 percent of cases. These tumors tend to be very dangerous when they do occur because they can spread quickly. A squamous cell carcinoma may appear as a raised bump, often on the lower eyelid. The tumor may cause the eyelashes in the affected area to fall out.
Melanoma does not develop on the eyelid often, yet it is responsible for a disproportionate number of deaths due to the speed with which this type of cancer can spread. A melanoma tumor may form on the eyelid surface or the conjunctiva that lines the eyelid. If a new growth appears or a mole starts to exhibit changes, it is important to seek medical attention.
Sebaceous Cell Carcinoma
These relatively rare tumors form in the meibomian glands of the eyelids where the substance that covers the eye is produced. Sebaceous cell carcinomas are sometimes not diagnosed immediately because they tend to resemble a sty. These tumors frequently metastasize to the structures of the eye or other nearby areas such as the lymph nodes, so it is essential to have the growth evaluated by a doctor.
Treatment of Eyelid Tumors
A biopsy will be taken of the tumor to determine whether it is malignant. If it is found to be cancerous, surgery will likely be necessary. In some cases, a benign pre-cancerous lesion will require removal as well.
The two goals of eyelid skin cancer surgery are complete removal and reconstruction. First, the tumor is removed and the tissue is tested to ensure that the entire malignancy has been excised. In those cases in which a tumor cannot be completely removed or the affected area is extensive, radiation therapy may be necessary in addition to surgery.
In the second phase of the procedure, the surgeon will reconstruct the eyelid so that it both functions properly and restores a normal appearance to the eye. The reconstruction surgery is tailored to each patient based on the size and location of the defect. There are many advanced techniques for removing eyelid skin tumors as well as for reconstructing the lid to preserve vision and obtain the most fully functional and cosmetically appealing outcome possible.