Eyelid Cancer Surgery and Treatment in London

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What is eyelid cancer?

 

Eyelid cancer is used to describe a number of malignant tumours of the eyelid and the different surgery options. They can originate from the skin, the sebaceous or fat glands or the apocrine or sweat glands. The most common types of eyelid cancer are:

Basal cell carinoma

Basal cell carcinoma (BCC) is the most common cause of eyelid cancer. It is more frequent in older patients and on the lower eyelid. It is related to fair skin and excessive sun exposure. They tend to grow slowly and are mostly curable with minimal damage when caught and treated early. Multiple BCC's can be associated with Gorlin Goltz syndrome. They develop from round cells in the epidermis of the skin which are also known as basal cells.

Sebaceous carcinoma

Sebaceous carcinoma is also known as sebaceous cell carcinoma, sebaceous gland carcinoma and meibomian gland carcinoma. It is an uncommon malignant tumour and can look like a persistent stye. They are more prevalent in older adults of Caucasian. asian and indian populations. Occasionally they are associated with Muir Torre syndrome.

Squamous cell carcinoma

Squamous cell carcinomas are also less commonly called epidermoid carinomas. It is a skin cancer that usually presents as a hard lump with scales but can also present as a ulcer. It is more likely to have distal spread than basal cell carcinoma. Bowen's disease is the precancerous form which has the ability to develop into squamous cell carcinoma.

 

Melanoma

Malignant melanoma are skin tumours that develop from the pigment cells in the skin known as melanocytes. Exposure to ultraviolet light sun exposure, having pale skin, a family history and multiple moles increases the risk of developing these rare malignant tumours.

 

What are the symptoms of eyelid cancer?

 

Eyelid cancer symptoms include:

  • Swelling of the eyelid

  • The eyelid appearing thicker

  • A non healing ulcer on the eyelid

  • A chronic infection that does not resolve

  • A spreading mass

  • Loss of lashes around an eyelid lesion

  • A general change in appearance in the eyelid skin

Is eyelid cancer curable?

 

Eyelid cancer is curable in many cases. Early detection and treatment results in a better the outcome.A small eyelid tumour that has been treated with complete removal with no spread to distal areas or to the nearby lymph nodes has the best outcome.

Does eyelid cancer look like a stye?

 

Sebaceous carcinoma is an eyelid cancer that presents with a yellowish nodule on the upper eyelid and can be mistaken for a stye. For this reason you should see you oculoplastic surgeon if you have a stye that does not return or recurs at exactly the same place. Most yellowish nodules on the eyelid are benign tumours that are not cancerous but should be assessed by a specialist.

 

What causes eyelid cancer?

 

The most important cause of eyelid cancer is exposure too sunlight and UV light from tanning. The DNA of the skin is at risk of damage from these resulting in cancer cells forming.

People who spend prolonged periods of time outdoors are use tanning beds frequently or live in sun all year round.are a increased risk. Those with pale skin and a family history of eyelid cancer are also at increased risk.

Is eyelid cancer deadly?

 

Basal cell carcinoma (BCC) are rarely deadly. Sebaceous, squamous and melanoma tumours are not deadly if detected and treated early. Once a cancer has spread deeper to other parts of the body treatment is more difficult and it can be deadly. Fortunately most tumours are detected early and survival is high at over 95%.

What does basal cell carcinoma look like on the eyelid?

 

Basal cell carcinoma (BCC) of the eyelid classically looks like a pearly nodule with a central ulcer surrounded by fine blood vessels. There may be some loss of eyelashes associated with it if it is on th eyelid margin. It can also look like a purple nodule and this can look similar to a more rare eyelid tumour known as Merkel cell carcinoma which is more aggressive.

 

BCC is most common on the lower lid followed by the medial canthus beside the nose. It is less common on the upper lid but can still occur in this area.

 

What are the treatment options for eyelid cancer?

 

Surgical excision remains the best treatment for eyelid cancer. If a lesion on the eyelid looks suspicious of cancer, photographs are taken and an incisional biopsy may be taken. This is where part of the tumour is taken as a surgical biopsy for analysis to determine what it is. Diagnostic tests are important to determine which treatment options are most suitable. Many biopsies can prove to be bengin tumours and not cancerous on analysis.

If the tumour is small enough and there a good amount of surrounding skin an excisional biopsy may be done where the tumour is removed completely in one go. This is a surgical procedure that can be done under local anaesthetic.

Many eyelid cancers are suitable for MOHs surgery. This is micrographic surgery where thin layers of the tumour are taken and analysed down to the lower epidermis of the skin until the tumour cells are completely removed. It helps keep any damage to he nearby tissues to a minimum. Following this procedure an eyelid reconstruction procedure is performed to close the area that has been treated.

If you are not able to have surgery for medical reasons or the tumour is not suitable for surgery, radiation therapy or topical chemotherapy may be an option depending on the nature of the cancer.

Radiotherapy and chemotherapy are also options for tumours that have spread to other parts of the body.