Abstract
Eyelid is a common place for skin cancer to occur and constitute 5–10% of all skin cancers. Eyelid neoplasms comprise a variety of benign and malignant growths. Significant majority of these growths are benign in nature and constitute 82–98% of all neoplasms. There is wide, racial, and probable geographical variation reported in the incidence of the various eyelid tumors. Eyelid malignancies vary in distribution and presentation. The most common malignant eyelid tumor in western literature is basal cell carcinoma (BCC) comprising 86–91% incidence among the Caucasians (Deprez and Uffer, Am J Dermatopathol 31:256–62, 2009; Gundogan et al., Asian Pac J Cancer Prev 16:4265–9, 2015). However, in one of the largest series from China and India where this incidence is much lower, consequently sebaceous gland carcinoma (SGC) constitutes 32% of all eyelid tumors (Ni, Zhonghua Yan KeZaZhi 32:435–7, 1996; Kale et al., Indian J Plast Surg 45:22–8, 2012). In studies from Asian countries (Prabha et al., Sch J App Med Sci 3:2165–8, 2015; Ho et al., Hong Kong Med J 19:150–5, 2013; Chang et al., Kaohsiung J Med Sci 19:549–54, 2003), it is the sebaceous gland carcinoma which constitutes the majority (67–77%). The mean age for benign tumor is lower than that of malignant tumors. Epithelial tumor and dermoid cysts are the most common eyelid tumor in children (Hsu and Lin, Ophthalmologica 218:274–7, 2004). Malignant eyelid tumor in children is extremely rare. When it presents, is usually a part of a systemic process, genetic defects or following radiation treatment (Al-Buloushi et al., Eye 19:1313–4, 2005; Nerad and Whitaker, Ophthalmology 106:723–9, 1988). Merkel cell carcinomas (MCC) of the eyelid are rare neuroendocrine tumor constituting 5–20% of the head and neck tumor, predominantly in Caucasians (Lemos et al., J Am Acad Dermatol 63:751–61, 2010).
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Keywords
- Cancer in the eyelid
- Eyelid cancer
- Basal cell carcinoma in the eyelid
- Sebaceous gland carcinoma in eyelids
- Squamous cell carcinoma of the eyelid
- Kissing nevus in the eyelid
- Squamous papilloma of the lower eyelid
- Xanthelesma in eyelids
Overview and Epidemiology
Eyelid is a common place for skin cancer to occur and constitute 5–10% of all skin cancers. Eyelid neoplasms comprise a variety of benign and malignant growths (Table 1.1). Significant majority of these growths are benign in nature and constitute 82–98% of all neoplasms (Table 1.2). There is wide, racial, and probable geographical variation reported in the incidence of the various eyelid tumors. Eyelid malignancies vary in distribution and presentation. The most common malignant eyelid tumor in western literature is basal cell carcinoma (BCC) comprising 86–91% incidence among the Caucasians [7, 12]. However, in one of the largest series from China and India this incidence is much lower, consequently sebaceous gland carcinoma (SGC) constitutes 32% of all eyelid tumors [6, 13]. In studies from Asian countries [2, 14, 15] it is the sebaceous gland carcinoma which constitutes the majority (67–77%). The mean age for benign tumor is lower than that of malignant tumors. Epithelial tumor and dermoid cysts are the most common eyelid tumor in children [16]. Malignant eyelid tumor in children is extremely rare. When it presents, is usually a part of a systemic process, genetic defects or following radiation treatment [17, 18]. Merkel cell carcinomas (MCC) of the eyelid are rare neuroendocrine tumor constituting 5–20% of the head and neck tumor, predominantly in Caucasians [19].
Classification of Eyelid Tumors
Eyelid tumors can arise from various histological layers eyelid is composed of. Eyelid tumors are classified as benign or malignant or according to the tissue or cell of origin (Tables 1.2, 1.3 and 1.4). They can be subdivided into non-melanocytic and melanocytic tumors. Benign epithelial proliferations such as squamous papilloma, pseudoepitheliomatous hyperplasia, seborrheic keratosis, keratoacanthoma cysts and nevi are common. Among the malignant, BCC (Figs. 1.1 and 1.2) is the most common in Caucasians and SGC among the Asians (Fig. 1.3), followed by squamous cell carcinoma (SCC) and malignant melanoma (MM) (Figs. 1.4, 1.5, 1.6, 1.7 and 1.8). The large majority of BCC (93%) was seen in 71% of females [2] SGC has predilection for the upper lid [20]. Merkel cell cancer has higher prevalence in men. Primary malignant melanomas of the eyelid skin are rare and account for 0.2–13% of all reported cases [2, 7]. They occur 20 years later than other non-melanoma tumor and have 2.6 times predilection for the lower lid. Eyelids can also be involved by secondary and metastatic lesions.
All primary carcinomas of the eyelid can be classified based on their clinical and histological presentation using the TNM [tumor, nodes (lymph), metastasis] by AJCC (8th Ed) classification system [21]. TNM staging describes the size of tumor, number and location of regional lymph nodes which have malignant cells in them and whether the malignant cells have spread or metastasized to another part of the body. The TNM classification of eyelid carcinomas reflects both morbidity and mortality risks in order to provide useful guidelines for patient management.
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Singh, U., Kolavali, R.R. (2019). Overview of Eyelid Tumors. In: Chaugule, S., Honavar, S., Finger, P. (eds) Surgical Ophthalmic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-18757-6_1
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