Eyelid cancer

Skin cancer is one of the most common cancers, especially among populations with fair skin, and the eyelid is a frequent target. In fact, up to 10 percent of all skin cancers form on the eyelids, and most appear on the lower eyelid. This condition occurs more frequently in adults between the age of 50 and 80, and rarely affects children and young adults.

Eyelid skin cancer is divided into two categories: melanoma and non-melanoma skin cancer (NMSC). Non-melanoma types are much more prevalent affecting millions of people every year.

The symptoms of eyelid skin cancer

A significant positive aspect of skin cancer is that it can be detected early, especially on the eyelids. This makes it much easier to treat and cure. The most common symptom of skin cancer is a mass on the eyelid skin. The skin may take on an unusual appearance, color or texture. The patient may also notice some thickening or scaling of the skin. Bleeding from the mass or a mass that does not heal completely may also indicate malignancy. Loss of eyelashes is a very strong indicator of eyelid cancer, while irregular borders and growth of the lesion indicate probable active growth of the mass.

The different types of eyelid skin cancer

As mentioned above, eyelid skin cancer falls into two categories: melanoma and NMSC. The eyelids are a common site for the two most frequent types of NMSC: basal cell carcinoma and squamous cell carcinoma.

Basal cell carcinoma (BCC)

Arises from basal cells which are found in the lower layer of the epidermis. Basal cell carcinomas make up about 90% of all cancers that appear on the eyelids. This cancer carries an excellent prognosis as it does not tend to metastasize; this means that the tumor produces local damage but will rarely travel to other organs. However, the tumor will produce significant local tissue damage if it is not removed promptly. Basal cell carcinoma appears as a “pearly” bump on the eyelid with a scaly surface. The mass grows slowly and does not go away with topical treatments.

A simple clinical examination may suspect basal cell carcinomas; however, the only sure way to make a diagnosis is to biopsy the mass. If in fact the mass is BCC, the surgeon will have to remove it completely. If diagnosed early, the cancer can be removed without leaving any impairment of eyelid function. On the other hand, if the mass has been present for a long time and tissue damage is extensive, the eyelid defect after cancer removal will be significant, and complex eyelid reconstruction will be necessary.

Squamous cell carcinoma (SCC)

Is the second most common cancer of the eyelids. It is also more aggressive than BCC. Squamous cell cancer arises from a more superficial layer of the epidermis, and although it resembles BCC clinically, the mass is usually flatter and produces more inflammation. A common form of SCC is a red, scaly patch that grows and does not heal. SCC has a poorer prognosis because it spreads to the deeper tissues of the orbit (eye socket) and has a higher tendency to produce metastasis.

Malignant Melanoma

is the most aggressive type of eyelid cancer. It usually surfaces as a pigmented