Malignant eyelid lesions: histopathological types and degree of tissue invasion at the time of presentation

Abstract

Introduction Although malignant eyelid tumors are rare, their incidence appears to be increasing. The recognition and treatment of malignant eyelid tumors pose a challenge. Moreover, late diagnosis of the tumors, although is rarely lethal, requires more invasive surgery and consequently will have adverse aesthetic effects. Objective The aim of this study was to evaluate histopathologically confirmed eyelid malignant lesions as regards pathological types and degree of tissue invasion at the time of presentation in patients admitted to the Oculoplastic Unit in Minia University Hospital during the 5-year period. Design This is a retrospective case series study that was carried out in the Oculoplastic Unit in Minia University Hospital during the 5-year period (from January 2009 to December 2013). Patients and methods Five years' medical records of all patients admitted to the Oculoplastic Unit at the Ophthalmology Department, Minia University Hospital, for the diagnosis and management of suspected eyelid lesions were reviewed. Data such as age and sex of the patients, laterality of the lesion, upper or lower lid lesion, site of the lesion, histopathological type of the lesion, grade of tissue invasion at the time of presentation, the procedure performed for each case, the recurrence if any and the follow-up period were evaluated. Results An overall 65% of eyelid malignancies were basal cell carcinoma (BCC), 23% were squamous cell carcinoma (SCC) and only 12% were sebaceous gland carcinoma (SGC). An overall 0.62% of the cases were confined to the lower eyelids and 38% were confined to the upper eyelids. An overall 88% of BCCs were confined to the eyelids and only 12% were extended deeper to the underlying periosteum. An overall 33% of cases with SCC and SGC extended deeper in the tissues or to the regional lymph nodes. Local recurrence after resection was nil in BCC, 16% in SCC and 33% in SGC. Conclusion In our locality, BCC represented two-thirds of the malignant eyelid lesions, whereas SCC was responsible for one-fourth of the lesions. Most of the malignant lesions were confined to the eyelid only. Although SGC was less frequent, it was aggressive and invasive; moreover, it had a higher rate of local recurrence.