Eyelid Tumors Research Articles

Abstracts from the 4th World Congress of the International Dermoscopy Society, April 16-18, 2015, Vienna, Austria

Background:In vivo confocal microscopy is an imaging technique that has been applied to the study of the ocular surface. However, confocal microscopes dedicated to eye examination are routinely adopted only in ophthalmology reference centres and do not allow an examination of periocular tissue, nor a fluorescence examination.Methods:We applied for the first time the two in vivo confocal microscopes commonly used in dermatology (VivaScope ® 1500 and 3000, CALIBER, distributed in Europe by Mavig GmbH, Munich, Germany) to observe the cornea, the bulbar and tarsal conjunctiva, the eyelid margin, the lacrimal punctum and the palpebral skin of healthy volunteers. Tumoral, inflammatory and infectious diseases of the ocular mucosa and periocular skin from more than 200 patients were observed under the same microscopes. Both microscopes have a reflectance mode. VivaScope® 1500 allows an additional fluorescent examination and its placement on the ocular surface was made possible by the creation of a special interface between the microscope and the ocular apparatus.Results:Thanks to its compact and flexible configuration, the handheld camera VivaScope® 3000 allowed to access more easily to the ocular and periocular tissues. Diagnosis of benign and malignant tumors (melanoma, squamous cell carcinoma and basal cell carcinoma), as well as infectious and genetic disease (storage diseases), could be evocated. The detection of parasites (Demodex folliculorum) on eyelids was possible. Confocal images correlated well with conventional histopathology. The fluorescence examination of corneal squamous cell carcinoma by VivaScope 1500 was characterized by extravasation of fluorescein after intravenous injection.Conclusions:Confocal microscopes dedicated to the skin offer new perspectives for the diagnosis, optimization of treatments, and follow-up of the ocular diseases. They will allow dermatologists to examine conjunctival and eyelid tumors, as it is for skin or genital mucosa. In addition, thanks to some adaptations of the dermatological device VivaScope® 1500, it is possible for the first time to perform a fluorsecnte examination of the ocular and periocular tissue, opening a new era in the clinical imaging of the ocular surface. A new semiology remains to be learned.

Clinical efficacy of repair for defect after xanthelasma removal with a subcutaneous pedicle flap based on the orbicularis oculi muscle

Objective To study the method and effect of subcutaneous pedicle flap based on the orbicularis oculi muscle in the treatment of xanthelasma. Methods According to the situation of xanthelasma and the soft tissues of upper eyelid, two new double-folds eyelid was designed. The soft tissues (including the skin and muscle) between two lines were intended to form a subcutaneous pedicle flap based on the orbicularis oculi muscle. Then, after the excision of xanthelasma from the surface of orbicularis oculi muscle, the flap was transferred to the defected site. Finally, a new double-folds eyelid was made. Results 13 cases with 25 sides were treated with a follow-up period of 3-6 months. All flaps were survived with good functions and the appearance of upper eyelids were satisfactory. Conclusions Subcutaneous pedicle flap based on the orbicularis oculi muscle is a reliable option for the treatment of xanthelasma. It has the advantages of abundant blood supply, convenience and effective. Key words: Eyelid neoplasms; Xanthelasma; Flap

Les carcinomes épidermoïdes des paupières. Bilan de 7 ans d’expérience au service d’ophtalmologie adulte du CHU de Casablanca

Malignant eyelid tumors generate considerable functional and aesthetic complications. Squamous cell carcinoma or squamous cell epithelioma (SCE) of the eyelids represents about 9% of all peri-ocular skin tumors. It is potentially lethal by orbital invasion or metastasis and characterized by clinical polymorphism and its ability to mimic other benign lesions of the eyelids, thus requiring early diagnosis and management. The goal of our work is to establish the epidemiological and clinical characteristics, treatment modalities and prognosis of SCE of the eyelids. This retrospective study was performed over a period of 7 years on 25 cases of SCE of the eyelids. The mean age was 62 years. The gender ratio was 1.77 with a male predominance. Twelve patients had precancerous lesions. Biopsy revealed squamous epithelioma SCE in 24 cases and a mixed carcinoma in one case. Surgical treatment was performed in 23 cases. Eyelid reconstruction was immediate in all cases. Radiation therapy (RTH) was carried out for additional 5 patients. The mean follow-up was 15 months. We noted 2 cases of recurrence; revision surgery was necessary in one case and radiotherapy in the other case. SCE is often diagnosed at advanced stages in our context because of the limited access to health care and the extreme clinic polymorphism. This explains the need for histological examination of any suspicious lesion. Prevention through photoprotection is essential.

Sebaceous adenomas of the eyelid and Muir-Torre Syndrome

Background/aimsSebaceous adenomas (SAs) are rare, benign sebaceous gland tumours of the eyelid. SAs may be associated with primary internal malignancies. This association is known as Muir-Torre Syndrome (MTS). The purpose...

Argon laser-assisted treatment of benign eyelid lesions.

We investigated the treatment of benign eyelid lesions with argon laser as an alternative therapy to surgical excision. The charts of 73 patients with 95 lesions treated with argon laser photocoagulation were reviewed retrospectively. In all patients, the procedure was performed for cosmetic reasons. The laser spot size ranged from 50 to 200 μm, the power varied from 300 to 700 mW, and the exposure time ranged between 0.1 and 0.2 s. The lesions were mostly located on the upper eyelid (66%); the lid margin was involved in 30 cases. The mean follow-up time was 7.2 ± 3.5 months (range 3-15 months). A histopathological diagnosis was confirmed for 81 lesions (85.3%). All patients were satisfied with the cosmetic result. No intraoperative complications occurred, and none of the patients complained of pain during laser application. All wounds epithelialized in 3-4 weeks with skin that appeared normal. Hypopigmentation of the treated areas were observed in three cases. No recurrence occurred during the follow-up period. Argon laser-assisted benign eyelid tumor excision is a useful, cheap, accessible, and well-tolerated alternative to traditional surgery.

Our histological results of the eyelids and conjunctiva tumour

INTRODUCTION: To review the histopathologic outcomes of our tumour excisions from eyelid and conjunctiva.METHODS: Forty-six hematological malignancy patients under induction and consolidation chemotherapy that expected We retrospectively studied the age, gender, tumour excision localization, and histopathologic outcomes of 81 patients who had undergone eyelid or conjunctiva tumour excision surgery between January 2012 and January 2015.RESULTS: Our study analyzed data of 81 patients, 37 (%46) of whom were male and 44 (%54) of whom were female. The mean age was 46,3 ± 18,9 (3-84 ) years. Sixteen patients had undergone conjunctiva tumour excision, 65 patients undergone eyelid tumour excision. From the cases who had eyelid tumour, 11 had squamous papilloma, 22 had intradermal nevus, 2 had seborrheic keratosis, 2 had epidermal inclusion cycst, 6 had inflammatory lesion, 1 had capillary hemangioma, 2 had xanthelasma, 3 had dermoid cycst, 2 had verruca vulgaris, 4 had sebaceous cycst, 1 had benign ecrine tumour, 1 had keratoacanthoma, 1 had pilomatrixoma. From the malignant tumours, 5 cases had basal cell carcinoma, 1 case had basosquamous cell carcinoma, 1 case had sebaceous glang carcinoma. From the conjunctiva tissues 4 pterygium, 6 conjunctival melanocytic lesion, and 6 pyogenic granuloma were observed.DISCUSSION AND CONCLUSION: The histopathologic diagnosis of eyelid and conjunctiva tumours might be affected by race, age, gender, residence, sunlight exposure, and the clinical research hospital's being a reference center.

Eyelid Tumors at the University Eye Clinic of Ioannina, Greece: A 30-year Retrospective Study.

Aims:The aim was to describe the epidemiology of primary eyelid tumors over a 30-year period at the Ioannina University Eye Clinic, Greece.Materials and Methods:This retrospective case series examined the histopathology of eyelid tumor specimens of patients treated between 1983 and 2012. Data were collected on patient age, gender, location of the lesion, extent of tumor excision and recurrence. Descriptive and inferential statistics were used to describe the study subgroups.Results:A total of 851 eyelid tumors comprised the study sample. There were 351 (41.2%) malignant cases and 500 (58.8%) benign cases. For malignant tumors, there were 86% basal cell carcinomas, 7% squamous cell carcinomas, and 7% basosquamous cell carcinomas. The benign eyelid lesions were comprised of 20% cysts, 18% seborrheic keratosis, 13% nevi, and 13% papillomas. Benign eyelid lesions occurred with equal frequency in the upper and lower lids. Malignant lesions were more frequently located in the lower lid. The mean age at diagnosis was 49 ± 1.45 years for patients with benign lesions and 67 ± 1.6 years for patients with malignant lesions.Conclusions:In this Greek cohort, benign eyelid lesions affected mostly young individuals, and malignant lesions occurred predominantly in elderly patients. Males and females were equally affected by malignant lesions, and recurrence after surgical excision was rare.

A clinicopathological study of eyelid tumours and its management at a tertiary eye care centre of Southern India

Background: Tumours of eyelids are common in people of both sexes and all age groups representing more than 90% of all ophthalmic tumours. Most of the tumours are diagnosed clinically. The treatment depends on site, extent of spread and the invasiveness of the tumour. Objective: To study the clinical presentations, types and management of eyelid tumours and its histopathological confirmation. Methods: A prospective study was conducted on patients presented with eyelid tumours to the Sarojini Devi Eye Hospital, Hyderabad during December 2007 to November 2009. Tumours were diagnosed clinically. Treatment was planned according to the nature of lesion. Data were presented as frequencies, mean ± Standard Deviation (SD). Unpaired t test was used to test the significance of difference of the type of the tumour with age, eye and eyelid involvement. Results: A total of 100 cases, 52 were females, 48 cases involved right eye, 61 cases were benign and 39 malignant. The mean age of the participant in benign tumour was 37.02 ± 16.847 years and of malignant tumour was 58.59 ± 11.271 years and this difference was statistically significant (p<0.05). There was no statistically significant difference observed in the context of type of tumour, eye and eyelid involvement (p>0.05). Commonest benign tumour was intradermal nevus with 17 cases, whereas Basal cell carcinoma and Sebaceous gland carcinoma presented equally in 16 cases each. Conclusion: A significant proportion of tumours were malignant, predominantly Sebaceous gland carcinoma and Basal cell carcinoma. Majority of malignant tumors were observed above 60 years of age.

Basal and lateral block resection for residual eyelid tumor during second stage reconstruction at 3 weeks

There are different techniques for reconstructing the eyelids and canthal area which may need modifications in some situations for proper reconstruction. Three cases of sebaceous gland carcinoma of the lids were done by different techniques, where the extent of the disease required subtotal lid excision. At 3 weeks when healing was noted and the histopathology reports were available, the second stage reconstruction was done along with tissue block excision. The block was excised from the site of graft-host junction showing margin involvement on histopathology. In the first case, the base of the excised margin showed infiltration following tumor excision, and hence a basal block of tissue was excised during second stage surgery. In the second case, the excised margin showed tumor involvement, so a lateral block of tissue was excised in second stage surgery. In the third case the deep basal block of tissue was excised during first stage only. In all the three cases, the excised block was free from tumor, but patient were kept on close follow-up. The technique has worked well in all the cases as no recurrence has occurred in 1-year follow-up. None of these patients received any radiotherapy or chemotherapy postoperatively. The postoperative appearances were normal with adequate functioning lids and earlier rehabilitation.

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

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.

Long-Term Evaluation of Tumor Removal at the Eyelid Margin Using a Radio-Frequency Electrosurgical Unit

Purpose: To evaluate the long-term follow-up results of the eyelid margin tumor resection using a radio-frequency electrosurgical unit. Methods: We retrospectively reviewed the medical records of 53 patients (55 eyes) diagnosed with eyelid margin tumor and who underwent eyelid tumor resection using a radio-frequency electrosurgical unit more than 5 years prior. Age, gender, undergoing a biopsy, recurrence,and complications were examined through phone questions and the out-patient department. Results: The study included 23 eyes of 22 males and, 32 eyes of 31 females, (age range 8.6-76.8 years). Surgical success rate was 95% (52 of 55 eyes) and mean follow-up period was 8.9 years. Thirty-four of 55 patients underwent a biopsy, and the most common cases were intradermal nevus and compound nevus (13 cases each), 2 cases of basal cell carcinoma (5.9%), 2 cases of actinic keratosis (5.9%), and, 2 cases of chronic inflammation (5.9%). Other cases included 1 case of squamous papilloma (2.9%) and 1 case of fibrosis (2.9%). There were 3 cases of recurrence. Eyelash-related complications after surgery occurred in 3 cases of trichiasis or distichiasis. Conclusions: Eyelid margin tumor resection using a radio-frequency electrosurgical unit is simple and showed high success rate. Additionally, it is considered as an effective method in the eyelid margin tumor resection due to low recurrence and complication rates in the long-term follow-up. J Korean Ophthalmol Soc 2015;56(8):1149-1153

English

AIM: To study distribution of eyelid tumors and confirmation of same with histopathological examination at Western Regional Institute of Ophthalmology of India. SETTING: M & J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, India. DESIGN: Case Series of Eyelid Tumors. MATERIALS AND METHODS: 120 patients of eyelid tumors were studied between June 2007 to July 2009, after initial clinical examination in relevant cases Ultrasonography, Ultrasound Biomicroscopy, Computed Tomography Scan, Magnetic Resonance Imaging done accordingly, Excision biopsy attempted in possible cases otherwise incisional biopsy done, all tumors were subjected to histopathological examination. RESULT: Male preponderance with male: female ratio (1.4: 1) was found in benign tumors, whereas amongst the malignant cases females outnumbered males (1.16: 1). Predilection for Right eye (R: L 1.4: 1) and Upper lid (U: L-1.14: 1) as an overall incidence was observed amongst the tumors. Amongst the malignant tumors, Meibomian Gland Carcinoma (46.34%) and amongst benign tumors Sebaceous Cyst (25.97%) was found to be maximum. CONCLUSION: All lid tumors should be subjected to histopathological examination to discern not only the diagnosis but also the management, as malignant tumors can often present as

Aspects épidémiologiques et cliniques des cancers oculaires primitifs du mélanoderme : notre expérience à propos de 111 cas

In this work, the authors aim to study clinical and epidemiological characteristics of ocular and orbital primary cancers in sub-Saharan African. This is a retrospective study over a period of 21 years, from 1984 to 2004, including all cases of ocular cancer, histologically proven after surgery of the globe or the orbit. For each patient, we studied the following parameters: age, sex, reason(s) for consultation, the affected eye, and histological result of the operative specimen. These data were collected by studying the departmental surgical registry, patient medical records and the tumor registry of the anatomicopathology laboratory of a tertiary care hospital in sub-Saharan Africa. We collected data on 111 black patients, among whom 15 cases (13.5%) presented with bilateral involvement, for a total of 126 eyes. The sex ratio was 1.17. Presenting signs showed a predominance of leukocoria (30.2%) followed by proptosis (21.7%) and in third place, protruding conjunctival mass (10.8%). Retinoblastoma was found most frequently, representing 66.6% of the oculo-orbital tumors and 95.45% of the tumors of the globe; followed by epidermoid carcinoma, representing 15.08% of cases. Malignant melanoma was third most common, representing 4.76%, with 83% arising in the anterior uvea and 7% in the choroid. Basal cell carcinoma and rhabdomyosarcoma follow in fourth place. Basal cell carcinoma constituted half (50%) of the eyelid tumors. Rhabdomyosarcoma was the most common orbital tumor in our series (57%). Next were lymphomas with conjunctival localization (2.38%), acute leukemia with orbital localization (1.59%) and rare tumors, palpebral dermatofibrosarcoma (0.79%), an orbital angiosarcoma (0.79%), a glioblastoma of the globe (0.79%) and a malignant solitary fibrous tumor of the orbit (0.79%). Ocular and orbital primary cancers in blacks remain tumors of the young, equally distributed between the sexes. Retinoblastoma is the most frequent, followed by epidermoid carcinoma. The globe is the preferential localization of these cancers.

Applying 3D-printing technology in planning operations of cancer patients

The purpose of this work was creation 3D model of the front part of the skull of the patient and evaluates the effectiveness of its use in the planning of the operation. To achieve this goal was chosen an operation to remove a tumor of the right eyelid, germinate in the zygomatic bone. 3D printing was performed at different peripheral devices using the method of layering creating physical objects by a digital 3D model as well as the recovery model of the skull with the entire right malar bone for fixation on her titanium frame to maintain the eyeball in a fixed state.

Histopathologic and Demographic Features of Eyelid Tumours

Ozel Vizyon Goz Dal Hastanesi, Mersin, Turkiye *Mersin Universitesi Tip Fakultesi, Patoloji Anabilim Dali, Mersin, Turkiye **Hitit Universitesi Tip Fakultesi, Deri ve Zuhrevi Hastaliklar Anabilim Dali, Corum, Turkiye ***Cankiri Devlet Hastanesi, Patoloji Klinigi, Cankiri, Turkiye ****Cankiri Devlet Hastanesi, Plastik Cerrahi Klinigi, Cankiri, Turkiye *****Ankara Universitesi Tip Fakultesi, Biyoistatistik Anabilim Dali, Ankara, Turkiye @Telif Hakki 2014 Turk Dermatoloji Dernegi Makale metnine www. turkdermatolojidergisi.com web sayfasindan ulasilabilir. @Copyright 2014 by Turkish Society of Dermatology Available on-line at www.turkdermatolojidergisi.com Engin Senel, Hitit Universitesi Tip Fakultesi, Deri ve Zuhrevi Hastaliklar Anabilim Dali, Corum, Turkiye Tel.: +90 364 223 03 00 E-posta: enginsenel@enginsenel.com Gelis Tarihi/Submitted: 12.05.2014 Kabul Tarihi/Accepted: 12.05.2014 Yazisma Adresi/ Correspondence: Objective: To assess the demographic, clinical and histopathological features of eyelid tumors. Methods: The records of the patients who have been operated for eyelid tumors at ophthalmology and plastic surgery clinics of our Hospital, between the years of 20112013 were evaluated retrospectively. Results: Fifty-four (40.9%) male and 78 (59.1%) female totally 12 patients of mean age 45 years (4-85) were recruited in this study. The location of tumor was upper lid in 74 (56.1%) patients, lower lid in 58 (43.9%) patients. Malign lid tumor was found in 8 patients of mean age 68.1 years (3 cases squamous cell carcinoma, 5 cases basal cell carcinoma). Benign lid tumours were found in 124 (93.9%) patients of mean age 43.1 years. Most commonly detected lid tumor was melanocytic dermal nevus in 39 cases (29.5%). Papilloma was seen in 36 (27.3%) patients, xanthelesma in 23(17.4%) patients, epidermal inclusion cyst in 14 (10.6%) patients, and seborrheic keratosis in 12 (9%) patients. Most commonly seen lid tumor was melanocytic nevus in females (34.6%) and papilloma in males (35.1%). Conclusion: In our study most commonly detected benign eyelid tumor was melanocytic nevus and most commonly detected malign eyelid tumor was basal cell carcinoma. Most of the eyelid tumours were benign. Benign tumours were most commonly seen between the age of 40-50 years and malign tumours between the ages of 60-70 years.

Eyelid tumours and surgical reconstruction

Die plastisch-rekonstruktive Lidchirurgie bietet eine Vielzahl an Operationsmethoden in einem anatomisch begrenzten Gebiet. Eine Auswahl der haufigsten Indikationen und der gangigsten Methoden werden in diesem Artikel vorgestellt. Ziel aller Lidrekonstruktionen ist eine moglichst vollwertige Wiederherstellung der normalen Lidfunktion bei einem asthetisch optimalen Ergebnis fur den Patienten [28]. Dabei muss besondere Rucksicht auf die einzelnen feinen Strukturen in dieser Region genommen werden, sodass die Integritat und Funktion der Lider postoperativ gewahrleistet ist.

Correlation of American Joint Committee on Cancer T category for eyelid carcinoma with outcomes in patients with periocular Merkel cell carcinoma.

Merkel cell carcinoma is a rare but potentially deadly cancer of the eyelid. To date, no studies have reported on clinical parameters at initial presentation of the eyelid tumor that may correlate with disease-free survival (DFS). The purpose of this study was to determine whether the American Joint Committee on Cancer (AJCC) T category for eyelid carcinoma correlates with metastasis and DFS in patients with Merkel cell carcinoma of the periocular region. This is a retrospective cohort study from a tertiary referral cancer center. All consecutive patients treated for eyelid or periocular Merkel cell carcinoma between November 1, 1998, and November 1, 2012, were reviewed. The main outcome measures included AJCC T category for eyelid carcinoma and Merkel cell carcinoma at presentation, nodal metastasis at presentation, metastasis during follow up, and DFS. The study included 18 patients, 7 men and 11 women, with median age of 68.5 years. The AJCC T categories for both eyelid carcinoma and Merkel cell carcinoma were significantly correlated with DFS. Using the T categories for eyelid carcinoma, when TX and T2a were grouped into a single category and T2b and T3a into another category, the estimated DFS rate at 3 years was 100% for patients with TX or T2a lesions and 57% for patients with T2b or T3a lesions (p=0.0298). Four patients (22%) had lymph node metastasis at presentation. Presence of lymph node metastasis at presentation was the strongest single predictor of shorter DFS and an increased risk of metastasis during follow up (p=0.0222). The AJCC eyelid carcinoma T at presentation correlates with DFS in patients with Merkel cell carcinoma of the periocular region. The DFS rate at 3 years was significantly worse for patients with T2b or more extensive tumors by eyelid carcinoma T category. Presence of lymph node metastasis at presentation was predictive of shorter DFS and an increased risk of metastasis during follow up.

Full thickness skin grafts in periocular reconstructions: long-term outcomes.

To evaluate the outcomes of eyelid reconstruction in patients who underwent full thickness skin grafts. A retrospective, noncomparative intervention study of patients who underwent periocular reconstruction with full thickness skin grafts between 2005 and 2011. One hundred consecutive Caucasian patients were included in the study, 54 women and 46 men. Mean follow up was 32 months. Indications for full thickness skin grafts were excision of eyelid tumors (98%) and cicatricial ectropion (2%). Site of lid defects were lower lid (60%), medial canthus (32%), upper lid (6%), and lateral canthus (2%). The skin graft donor sites were supraclavicular (44%), upper eyelid (24%), inner brachial (18%), and postauricular (14%).Early postoperative complications included lower eyelid graft contracture (1%) and partial failure (1%). Late sequelae included lower eyelid graft contracture (4%) and hypertrophic scarring (23%). Of the 23 patients with hypertrophic scar, 21 achieved good outcomes following massage with silicone gel and steroid ointment and 2 had persistent moderate lumpiness. No statistically significant association was found between graft hypertrophy and donor site or graft size. As high as 95% of all patients achieved good final eyelid position. Good color match was seen in 94% and graft hypopigmentation in 6%. An association between hypopigmentation and supraclavicular and inner brachial donor site was found to be statistically significant. Most patients (94%) achieved good eyelid position and color match. Majority (91%) of the early postoperative cicatricial sequelae can be reversed by massage, steroid ointment, and silicone gel application. Full thickness skin grafts have excellent graft survival rates and have minimal donor site morbidity.

Comparison of HER2 gene amplification and KRAS alteration in eyelid sebaceous carcinomas with that in other eyelid tumors

Eyelid sebaceous carcinoma (SC) represents a highly aggressive malignancy. Despite the poor prognosis, genetic alterations as potential molecular targets are not available. KRAS mutation and HER2 gene amplification may be candidates related to their genetic alterations. We examined the HER2 and KRAS alteration status in eyelid SCs and compared it with that in other eyelid tumors. The controversial topics of the human papillomavirus (HPV) and p16 expression were also investigated. HER2 amplification was determined by silver in situ hybridization, while immunohistochemistry was performed to study protein expressions in 14 SCs and controls, including 23 other eyelid malignancies and 14 benign tumors. Peptide nucleic acid-mediated PCR clamping and direct sequencing were used to detect KRAS mutations. HER2 protein overexpression was observed in 85.7% (12/14) of the SCs, of which two-thirds showed HER2 gene amplification. HER2 protein overexpression and HER2 amplification were found more frequently in eyelid SCs than in other eyelid tumors. All SCs harbored wild type KRAS genes. No HPV infections were identified in the SCs. Nevertheless, p16 overexpression was found in 71.4% (10/14) of SCs, irrespective of the status of HPV infection. Furthermore, p16 overexpression in eyelid SCs was also significantly higher than that in other eyelid tumors. HER2 protein overexpression, HER2 gene amplifications, and wild type KRAS genes are common in eyelid SCs. HER2 gene amplification may represent potential therapeutic targets for the treatment of eyelid SCs.

English

The purpose of this study was to evaluate the proportion of eyelid tumors, compare the clinical diagnosis with histopathological diagnosis in all possible cases in a tertiary eye hospital over a 5-year period. MATERIALS AND METHODS: Retrospective chart review was performed for patients with eyelid tumors from June 2009 to June 2014.Data were collected and analyzed on location of tumor, types of treatment, and pathologic findings. Histopathological diagnosis of benign and malignant tumors was stratified based on age, gender and tumor location. RESULTS: Total number of 235 patients was evaluated of which, 216 (91.9%) cases were benign and 19(8.1%) cases were malignant neoplasms. Most common benign tumors included epidermal cyst(30.5%), nevi (17.5%), dermoid cyst (13.8%) and papilloma (6.5%).Most frequent malignant tumors included Sebaceous gland carcinoma (SGC) (31.6%), Basal cell carcinoma (BCC) (26.3%), Squamous cell carcinoma (21%), Malignant melanoma (10.5%), Merkel cell carcinoma(5.3%) and Lymphoma (5.3%).Most common site for malignancy was lower lid followed by upper lid. BCC recurred in 1case in lower lid. CONCLUSION: Epidermal cyst, nevi, dermoid cyst and papilloma are the most common benign lesions and SGC is the most common malignant lesion. Recurrence is a feature of BCC in lower lid.