Eyelid Tumours

Eyelid tumours are abnormal eyelid growths that can be benign or malignant. A malignant tumour may also be referred to as eyelid cancer or eyelid skin cancer. Treatment options vary based on the type of tumour, but early detection and specialised care play crucial roles in successful outcomes. The trusted specialists at The Ezra Clinic assess any eyelid lesions and recommend optimal management for health, improved appearance, and peace of mind.

Key Information

PRICE

Call for more info

TIME OF PROCEDURE

Depends on several factors

DOWNTIME

2-3 weeks

DISCOMFORT LEVEL

4 out of 5

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What Are Eyelid Tumours?

An eyelid tumour is an abnormal mass of new tissue that forms on the upper or lower eyelid. Some tumours are benign, which means they are not cancerous. Other tumours are malignant, which means they can infiltrate tissues surrounding the lesion and spread to other body parts, a process called metastasis.

The eyelid is a common site for tumours because of its high exposure to the sun. The tissues of the eyelid are also structurally different from the rest of the body at a microscopic level. Malignant tumours can spread rapidly, and often, the tumour roots extend beyond the area visible on the skin’s surface. For this reason, it is important to be assessed as soon as a new lesion is noticed.

What Are the Types of Eyelid Tumours?

Multiple benign lesions occur on the eyelids, especially as we age. These include cysts, skin tags, and moles. It can sometimes be challenging to differentiate between benign and malignant lesions by relying solely on examination findings and the patient’s medical history. We often recommend a biopsy to exclude a malignant lesion. If left untreated, malignant growths can lead to serious consequences.

The most common types of malignant eyelid tumours are:

Basal Cell Carcinoma – BCCs are the most common form of eyelid tumour, accounting for 90% of malignant eyelid neoplasm diagnoses. A BCC usually presents as a raised, pearly lesion on the eyelid margin. These are unlike other forms of cancer in that they do not spread to other parts of the body. They can, however, grow quite large locally and invade other tissues. This type of tumour is more common in fair-skinned people and usually affects older individuals, although they may impact younger people too.

Squamous Cell Carcinoma – SCCs are an aggressive form of skin cancer formed from squamous cells found on the top layer of the skin. SCCs can spread rapidly to other body parts, although most SCCs are curable when caught early. SCCs have many presentations, from scaly, pink skin to a keratinised horn.

Sebaceous Gland Carcinoma – SGCs are very rare but aggressive tumours that grow from the sebaceous glands found in the eyelids. These glands produce the oil that forms part of the tear film and prevents tears from evaporating too quickly. SGC tumours are often misdiagnosed as chalazion or blepharitis. Therefore, it is recommended that you see an eyelid specialist if you have unilateral blepharitis or a non-resolving chalazion, particularly if you do not usually get chalazia or there are other suspicious features such as loss of eyelashes or crusting.

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What Are the Eyelid Tumour Symptoms?

Most eyelid tumours in their early stages are asymptomatic, meaning you may not have any symptoms. Eyelid tumour symptoms can vary but are commonly characterised by skin changes such as raised eyelid bumps, which may or may not be pigmented. In more advanced stages, tumours can ulcerate, display scaling and crusting, or even split the skin and cause bleeding.

If the cancer has started to spread, patients may experience swelling of the lymph nodes around the ear and under the chin. Patients may present with orbital pain, reduced vision, double vision, or eye displacement in later stages.

Basal cell carcinomas usually present as a painless hard lump, most commonly in the lower eyelid, that grows to break down deeper tissue. Loss of eyelashes is an indicator of a malignant tumour.

Squamous cell carcinomas may appear as a non-healing ulcer on the eyelid with hard, raised edges featuring redness, crusting, or bleeding. Patients may experience decreased vision if the cancer spreads behind the eye.

Sebaceous gland carcinomas commonly present as a small, firm red or yellow lump on the eyelid. This may gradually increase in size and irritate the eye.

What Are the Causes of Eyelid Tumours?

In most cases, the direct cause of a tumour is not known. However, there are risk factors which have been proven to increase the risk of eyelid tumours.

Excessive sun exposure and consequent skin damage, especially in fair-skinned individuals, is a major risk factor. Genetics plays a role, as does a suppressed immune system, due to medication or disease. Pre-malignant lesions such as Bowens Disease, actinic keratosis, and keratoacanthomas may develop into malignant lesions if left untreated.

At The Ezra Clinic, our team works tirelessly to ensure you have the most accurate diagnosis and treatment options for eyelid tumours. Contact us for more information.

What Are the Complications That Come With Eyelid Tumours?

Overall, eyelid tumours are relatively uncommon, with low rates of spread. Nevertheless, tumours can pose a high risk of damage to nearby eye structures, potentially leading to complications ranging from dry eyes or incomplete eye closure to double vision or, rarely, blindness. Certain cancers may spread to the rest of the body if left untreated.

What Is the Process for Tumour Diagnosis and Management?

The first step is an accurate diagnosis via a detailed exploration of your medical history and an eye examination. Many benign lesions have typical features, allowing our experts to reassure you that there is no cause for concern quickly. Sometimes, a biopsy is required for a definitive diagnosis, which is performed as a day-case procedure under local anaesthetic. The area is numbed with a small injection, and a lesion sample is sent to the laboratory for histopathological assessment. The results of the biopsy are usually available within one week.

Your ophthalmologist will review the biopsy results and explain treatment options to you. An excision and reconstruction will be planned if the biopsy reports a BCC. With other forms of skin cancer, further investigations, including blood tests, scans, and ultrasounds, will often be arranged in addition to the excision and reconstruction.

At The Ezra Clinic, tumours can be excised either by Mohs micrographic surgery (see below) or with a margin of a few millimetres of normal tissue. A lid reconstruction will be planned following the excision of the tumour.

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What Are the Treatments for an Eyelid Tumour?

A benign tumour on eyelid skin does not usually require treatment as long as it is not causing problems. However, when a tumour interferes with your vision, causes eye irritation, or creates distress due to its cosmetic appearance, it may be surgically removed. The type of eyelid tumour removal will depend on the severity of your tumour.

There is a wide range of treatment options available at The Ezra Clinic. Your ophthalmologist will advise you on the best course of treatment.

Treatment options for eyelid malignancy include:

Topical chemotherapy – A chemotherapy ointment applied directly to the tumour.
Topical immune response modifiers – Topical creams used to cause a localised inflammatory reaction which kills the tumour cells.
Cryotherapy – An ice-cold metal probe is used to destroy the cancer cells.
Laser treatment – A focused beam of light destroys the cancer cells.
Radiation – The tumour is exposed to high-powered X-ray beams to kill the cancerous cells.
Surgery – The tumour is usually surgically removed by a Mohs surgeon, and an oculoplastic surgeon performs the reconstruction during a separate operation. Alternatively, if the tumour is small and well-defined, it may be removed and reconstructed in a single operation by an oculoplastic surgeon.
Systemic chemotherapy – Patients with advanced disease may be treated with chemotherapy drugs to treat the tumour and any metastases.

What Is Mohs Surgery?

Mohs surgery is performed in stages. First, the Mohs surgeon, usually a dermatologist (skin specialist), excises the area they believe to be involved with the tumour and examines this under the microscope. If surgical margins contain the tumour, a second-stage surgery will remove further tissue in this area. The process is repeated until the tumour has been completely removed.

The Mohs surgical procedure has two main advantages. Firstly, it has a very high cure rate as the dermatologist can be confident that the tumour has been completely excised. Secondly, Mohs allows you to keep as much healthy skin as possible because the dermatologist only removes the affected skin. This is especially important on the eyelid when preserving as much normal tissue as possible.

What Is Reconstruction?

Skin tumours have roots that often extend much further than those visible on the skin’s surface. Following the excision of a tumour, patients may have a defect much more extensive than expected from a relatively minor skin lesion. In some cases, the skin edges may be pulled together. Various techniques can be used to treat more significant defects, including skin flaps or grafts from other body parts. Eyelids have an excellent blood supply and usually heal exceptionally well following reconstruction.

Post-Surgery Advice

Your Ezra Clinic specialist will provide an easy-to-follow post-operative aftercare regimen. They will also arrange follow-up visits to monitor the healing of your eyelid and to check for any recurrence of lesions.

Eyelid Tumours – eyelid cancer – images

If you have any questions about the procedure or aftercare, contact the team at The Ezra Clinic. We can answer any questions and set your mind at rest if you’re concerned about your recovery.

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