Clinicopathological Characteristics of Malignant Eyelid Tumor in Korea

PURPOSE: To determine the clinical characteristics of patients with malignant eyelid tumors in Korea. METHODS: We performed a retrospective review of the medical records of 73 patients with malignant eyelid tumors who were histologically diagnosed at Seoul St. Mary's hospital from April 2004 to September, 2012 and followed for 6 months or longer. RESULTS: Of 73 cases, 41 (56.2%) were diagnosed as basal cell carcinoma, 17 (23.3%) as squamous cell carcinoma, 11 (15.1%) as sebaceous gland carcinoma, 3 (4.1%) as malignant melanoma, and 1 (1.4%) as basosquamous cell carcinoma. The mean age at diagnosis was 68.4 +/- 11.5 years. Tumors developed more commonly on the lower lid (54.8%). Most cases were treated by complete resection of tumors and eyelid reconstruction (95.9%). The prognosis of patients with basal cell carcinoma and squamous cell carcinoma was good, while that of the other tumors was relatively poor. CONCLUSIONS: The most common diagnosis was basal cell carcinoma (56.2%). Recurrence after complete surgical excision and reconstruction was uncommon.

A clinical review of eyelid sebaceous carcinoma

Malignant tumors of the eyelid pose a serious threat because of their proximity to the globe, brain & paranasal sinuses. Three types of carcinomas account for the vast majority of the malignant eyelid tumors: basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma. In these malignancies, basal cell carcinoma is the most common. However, sebaceous gland carcinoma has a high recurrence rate and a moderately high 5-year mortality rate because of late diagnosis and incomplete surgical removal. This tumor may be clinically misdiagnosed frequently as a chronic unilateral conjunctivitis, chalazion, basal cell carcinoma, or squamous cell carcinoma in initial biopsy. Suspicious lid lesions should be managed with incisional biopsy initially. If they are positive for sebaceous gland carcinoma, wide excision and frozen section monitoring of surgical margin is the treatment of choice. The final diagnosis should be confirmed by special stain for lipid. We experienced 12 cases of malignant eyelid tumors including 3 cases of sebaceous gland carcinoma. In cases of sebaceous gland carcinoma, wide surgical excision with frozen section monitoring was performed and followed by eyelid reconstruction with intact eyelid tissue remained and adjuvant radiotheraphy. Guidelines for management are discussed.

Classification and Therapeutic Effect of Benign and Malignant Eyelid Tumors

The authors reviewed 73 cases of the eyelid tumors diagnosed histopathologically at Department of Ophthalmology, Yeungnam University Medical Center from March, 1984 to December, 1995. Twenty-three persons were men and fifty persons were women. The benign tumors were distributed evenly in all decades, but the malignant tumors were noted frequently in seventh and eighth decades. Histologically, benign tumors were 58 cases and malignant tumors were 15 cases. The frequency of benign eyelid tumors was noted in this order : nevus, cyst, squamous papilloma, hemangioma, seborrheic keratosis. Malignant eyelid tumors included 10 cases of basal cell carcinoma, 5 cases of meibomian gland carcinoma. The location of the benign tumors of the lids was noted in this order : the upper eyelid(30 cases), the lower eyelid(23 cases), the medial canthus(3 cases) and both eyelids(2 cases). In malignant tumors, the locations of basal cell carcinoma were the lower eyelid(6 cases), the medial canthus(3 cases) and the upper eyelid(1 case). Meibomian gland carcinoma was found in the upper eyelid(3 cases) and in the lower eyelid(2 cases). Excisional biopsy was performed in all of benign tumors(58 cases, 100%). For the treatment of the malignant tumors, simple excision(5 cases, 33%), excision and reconstruction(6 cases, 40%), excision and skin graf(3 cases, 20%) were performed. Exenteration and several courses of radiation therapy were carried out for a recurred meibomian gland carcinoma(1 case, 7%).