Abstract
Background Eyelid tumours are common in our ophthalmic practice. Malignancy cases account only for one-fourth of all eyelid tumours. The most aggressive eyelid malignancy is sebaceous gland carcinoma, but its occurrences are rare in western countries. We found sebaceous gland carcinoma is as common as basal cell carcinoma in our clinical practices. Hence, it is essential to build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Aim To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Methods This was a retrospective case series study of 332 patients in Bangladesh. This study analyzed all the recorded data of the histologically proven primary eyelid malignancies and followed them up for at least six months from 2014 to 2019 (6 years). All patients were managed by surgical excision with tumor-free margins verified on histopathology, either the frozen section or excision biopsy with 2–3 mm microscopic view of normal tissue followed by eyelid reconstruction. Computer-based statistical software SPSS was used for the analysis, and an appropriate test of significance (chi-square) was used for the statistical analysis. Results Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). The mean age at presentation of SGC, BCC, SqCC, and MM were 57.41 years, 62.56 years, 64.73 years, and 59.28 years, respectively. Female (59%) was slightly more preponderance over the male (41%) for SGC than other malignancies. Pigmentation was associated with malignant melanoma (100%) and BCC (81%). Statistically, a significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness. The recurrence rate was low lower in the patients who underwent frozen section biopsy (3%) for margin clearance than those who underwent excision biopsy (21.5%) in the follow-up time. Conjunctival map biopsy (8%) was performed as an essential tool for excluding the pagetoid spread of SGC. A new reconstruction method named triangular-shaped musculocutaneous tail flap was performed in 33 (11%) patients to reconstruct the moderate eyelid defect following local resection. Conclusion Sebaceous gland carcinoma (SGC) was the highest occurrence found to be the highest occurrence among all eyelid malignancies in Bangladesh. SGC is more aggressive and the recurrence rate was higher than BCC and SqCC.
Highlights
Eyelid carcinoma is the most common malignant neoplasm of the eyelid region, and it may involve either the skin or the tarsus and inner layer of the eyelid [1]
Males were more preponderant than females in the cases of basal cell carcinoma (BCC) (60.3%), squamous cell carcinoma (SqCC) (68.3%), and MM (57%). e Pvalue was highly significant (
Malignant eyelid tumors are rare in children and young adults but occur more commonly in the sixth, seventh, and eighth decades of life [12, 37, 38, 43–45, 48, 49]. e reported age range of the patients was 11 years to 94 years, and about 45% of the patients were aged between 60 and 70 years [31]. e incidence of BCC is higher in people over 60 years of age [31]
Summary
Eyelid carcinoma is the most common malignant neoplasm of the eyelid region, and it may involve either the skin or the tarsus and inner layer of the eyelid [1]. E most common primary eyelid malignancy is BCC which is rarely metastatic Other carcinomas such as SqCC, SGC, malignant melanoma, and Markel cell carcinoma are associated with more spreading in nature to the surrounding structures and a more pronounced metastatic potential [3, 4, 6–8]. In Asian countries, the SGC accounts for 27% to 53% and is as common as BCC [11–20]. Aim. To assess the relative frequency of eyelid malignancies in the Bangladesh population, state their clinical features and outcome of management strategies and build awareness about the more aggressive eyelid malignancies to reduce morbidity and mortality. Sebaceous gland carcinoma (SGC) was the highest in occurrence, at 42%, followed by 38% basal cell carcinoma (BCC), 18% squamous cell carcinoma (SqCC), and 02% malignant melanoma (MM). A significant difference was found between eyelid malignancies, including location, size, pigmentation, recurrence, and invasiveness
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