Lid Tumours

What is a lid tumour?

Eyelid tumours are very similar to skin tumours except they form on the upper or lower eyelids. They can be non-invasive (benign) or invasive (malignant).

What are the types of eyelid tumours?

Common benign eyelid tumours are:

• Nevus— These are freckles with or without color that form on the eyelid or eyelid margin. These rarely become malignant.
• Papilloma— A painless growth that is similar to a skin tag and most often seen in middle-aged or elderly people. These rarely become malignant.

Common malignant eyelid tumours are:

• Basal cell carcinoma— The most common malignant eyelid tumour, basal cell carcinoma appears as a small lump. It is most often found on the lower eyelid and is more common in fair-skinned people between the ages of 50 and 80. It usually doesn’t spread, but basal cell carcinoma can grow deep into the soft tissues locally.
• Squamous cell carcinoma— An aggressive tumour of the outer layer of the skin. It often results from excessive sun exposure and is usually found on the upper eyelid. 
• Sebaceous carcinoma— A rare, but potentially fatal tumour that is called the “great masquerader” because it is easy to mistake it for a stye or chronic eye inflammation. Usually this kind of tumour is found in people in their late 50s to early 70s. It can spread to the lymph nodes in front of the ears or underside of the jaw. The chances of dying increase with the size of the tumour.

What are the symptoms of a lid tumour?

Eyelid tumour symptoms can vary, but commonly include:

• Eye skin changes— Advanced stage tumours can ulcerate or display scaling or crusting.
• Lesions— Tumors may appear as lumps, bumps or lesions on or under the skin of the eyelids.
• Loss of eyelashes— Tumors located near eyelashes may result in loss of eyelashes.

How can eyelid tumour be diagnosed?

Ophthalmologists carefully examine any abnormality on the eyelid to diagnose a tumour, and usually confirm the diagnosis through a surgical biopsy. If the doctor suspects that the cancer has spread beyond the eyelid he or she may also use additional diagnostic tests including:

• imaging tests, such as CT or CAT (computed axial tomography) scans or MRI (magnetic resonance imaging) scans.
• sentinel lymph node biopsy. Surgeons remove the sentinel lymph node, the regional node to which cancer is likely to spread, and analyze it for the presence of cancer cells.

Early detection is essential, because some of these cancers have the ability to infiltrate inward along the deeper layers of the skin and through the bones and sinuses around the eye.

What are the treatment options for lid tumour?

Usually benign tumours don’t require active treatments, although they should be watched for changes. Those that become troublesome cosmetically, interfere with vision, or cause other eye irritations can be surgically removed.

Suspicious tumours require biopsy. If cancer is found, treatment options include:

• Cryotherapy— The doctor uses a very cold metal probe to destroy cancer cells.
• Laser treatments— A focused beam of light destroys cancer cells.
• Radiation— High-powered X-ray beams are directed to the site of the tumour to kill the cancer cells.
• Surgical excision— Removal of the tumour with surgery.
• Topical chemotherapy— Chemotherapy cream or lotion is applied directly to the tumour.

Prevention of eyelid tumour?

The best way to protect the delicate skin around the eyes from damaging light from the sun is to wear sunglasses that block ultraviolet light and a wide-brimmed hat. Use a broad-spectrum, SPF 15+ moisturizer on the eyelid region rather than sunscreen, since the eyelid skin will absorb moisturizer better than sunscreen.

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