Eyelid tumors are abnormal growths of tissue that can develop on or within the eyelids. These growths are a common occurrence and vary in their nature, ranging from noncancerous to cancerous forms. Understanding these growths helps in seeking appropriate medical guidance.
Benign and Malignant Growths
Eyelid tumors are categorized as either benign (noncancerous) or malignant (cancerous). Benign growths do not typically spread to other parts of the body, though they can enlarge and cause irritation or interfere with vision. Common benign eyelid growths include:
Chalazia, which are slow-forming red bumps due to blocked oil glands.
Styes (hordeola), which are painful red bumps caused by bacterial infections in oil glands.
Nevi, presenting as freckles or moles on the eyelid skin.
Papillomas, which are painless, wart-like growths that can be smooth or rough.
Seborrheic keratosis, a common raised, wart-like lesion.
Malignant eyelid tumors are cancerous growths capable of invading surrounding tissues and potentially spreading to distant sites. Basal cell carcinoma (BCC) is the most common type, accounting for approximately 90% of diagnoses. It often appears as a small, pearly lump, usually on the lower eyelid, and can grow deeply into local soft tissues. Squamous cell carcinoma (SCC) is a more aggressive type that forms from the skin’s outer layer and can spread quickly if untreated. Other types include sebaceous carcinoma, a rare but aggressive tumor from the eyelid’s oil glands, and melanoma, a more aggressive skin cancer that can spread to nearby lymph nodes and other body parts.
Warning Signs and Characteristics
Recognizing changes in eyelid appearance can prompt a timely medical evaluation. A new growth or lump on the eyelid, especially one that persists for several weeks, warrants attention. Changes in the skin’s appearance, such as reddish patches, discoloration, or areas with irregular pigmentation, are also important indicators.
Several other signs warrant medical attention:
Persistent swelling or thickening of the eyelid, especially if localized without an obvious cause.
A chronic infection or inflammation that does not resolve with typical treatments.
Open sores or ulcerated areas along the lash line or lid margin that bleed intermittently, scab over, or fail to heal within three weeks.
Loss of eyelashes in a specific area without regrowth.
Any change in a pre-existing mole on the eyelid, including alterations in color, size, or shape.
Diagnostic Procedures
When a suspicious eyelid growth is present, a doctor begins a diagnostic process. The initial step involves a comprehensive visual examination of the eyelid and surrounding eye area. A medical professional may use a magnifying lamp, such as a slit lamp, to closely inspect the lesion for characteristics, size, and extent.
The definitive method to diagnose an eyelid tumor is a biopsy. During this procedure, a small tissue sample is removed, typically under local anesthesia. The sample is then sent to a pathology laboratory for microscopic examination by a pathologist. This analysis confirms if the growth is benign or malignant and identifies the cell type, guiding treatment decisions.
Medical Interventions
Following a diagnosis, various medical interventions are available. Surgical excision is a common approach, particularly for malignant tumors. This procedure involves removing the tumor along with a margin of healthy surrounding tissue to ensure all cancerous cells are removed. The removed margin’s size can vary, typically 3 to 15 millimeters, depending on the tumor’s characteristics and risk factors.
Mohs micrographic surgery is a specialized technique often used for eyelid cancers like basal cell and squamous cell carcinomas. In this procedure, the surgeon removes the visible tumor and immediately examines thin tissue layers under a microscope. Additional layers are removed one at a time, with immediate examination, until no cancer cells are detected at the margins, preserving healthy tissue.
Other treatment options include:
Cryotherapy, which uses cold temperatures to destroy cancer cells, sometimes for low-risk basal cell carcinomas, though less common on eyelids due to recurrence rates.
Radiation therapy, using X-ray beams, for very large or extensive tumors, or when surgery is not feasible.
Topical chemotherapy, a cream or lotion, for certain low-risk basal cell carcinomas or in-situ squamous cell carcinomas.