Eyelid tumours

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EYELID TUMOURS -SOLANKI RIDDHI 2 ND YEAR (B.OPTOM)

Transcript of Eyelid tumours

EYELID TUMOURS

-SOLANKI RIDDHI

2ND YEAR (B.OPTOM)

Almost all types of tumours arising

from the skin, connective tissue,

glandular tissue, blood vessels,

nerves & muscles can involve the lids.

A few common tumours are listed

here.

CLASSIFICATION1. BENIGN TUMOURS

1. Papillomas

2. Xanthelasma

3. Haemangioma

4. Neurofibroma

2. MALIGNANT TUMOURS

1. Basal-cell Carcinoma

2. Squamous cell Carcinoma

3. Sebaceous Gland Carcinoma

4. Malignant Melanoma (Melanocarcinoma)

1. BENIGN TUMOURS

1. Papillomas:

These are the most common benign tumours arising from the surface epithelium.

i. Squamous papillomas occur in adults, as very slow growing or stationary, raspberry-like growths or as a pedunculate lesion, usually involving the lid margin.

ii. Seborrhoeic keratosis occurs in middle-aged & older persons. Their surface is friable, verrucous & slightly pigmented.

TREATMENT:

Simple excision.

SQUAMOUS PAPILLOMAS

SEBORRHOEIC KERATOSIS

2. Xanthelasma:

These are creamy-yellow plaque-like lesions which frequently involve the skin of upper & lower lids near the inner canthus.

Xanthelasma represents lipid deposits in histiocytes in the dermis of the lid.

These may be associated with diabetes mellitus or high cholesterol levels.

TREATMENT:Excision may be advised for cosmetic

reasons; but recurrences are common.

XANTHELASMA

3. Haemangioma:

Haemangiomas of the lids are common tumours. i. Capillary haemangioma: Is the most common variety which

occurs at or shortly after birth, often grows rapidly & in many cases resolves spontaneously by the age of 7 years.

These may be superficial & bright red in colour or deep & bluish or violet in colour.

They consists of proliferating capillaries & endothelial cells.

TREATMENT:Excision, Intralesional steroid,

Superficial radiotherapy.

CAPILLARY HAEMANGIOMA

ii. Naevus flammeus (port wine stain):

It may occur side-by-side or more

commonly as a part of Sturge-Weber

syndrome.

It consists of dilated vascular channels &

does not grow or regress like the capillary

haemangioma.

iii. Cavernous haemangioma:

Are developmental & usually occur after

first decade of life.

It consists of large endothelium-lined

vascular channels & usually does not show

any regression.

TREATMENT:

NAEVUS FLAMMEUS

CAVERNOUS HAEMANGIOMA

4. Neurofibroma:

Lids & orbits are commonly affected in

neurofibromatosis (von Recklinghausen’s

disease).

The tumour is usually plexiform type.

NEUROFIBROMA

2. MALIGNANT TUMOURS

1. Basal-cell Carcinoma:

It is the commonest malignant tumour of

the lids (90%) usually seen in elderly

people.

It is locally malignant & involves most

commonly lower lid (50%) followed by

medial canthus (25%), upper lid (10-15%)

& outer canthus (5-10%).

TREATMENT:

Surgery, Radiotherapy & Cryotherapy.

CLINICAL FEATURES OF BASAL-

CELL CARCINOMA

It may present in four forms:

Noduloulcerative basal cell carcinoma is the most common presentation.

It starts as a small nodule which undergoes central ulceration with pearly rolled margins.

The tumour grows by burrowing & destroying the tissues locally like a rodent & hence the name rodent ulcer.

Other rare presentations include: non-ulcerated nodular form, sclerosing or morphea type & pigmented basal cell carcinoma.

BASAL-CELL CARCINOMA

2. Squamous cell Carcinoma:

It forms the second commonest

malignant tumour of the lid.

Its incidence (5%) is much less than the

basal cell carcinoma.

It commonly arises from the lid margin

(mucocutaneous junction) in elderly

patients.

Affects upper & lower lids equally.

TREATMENT:

Treatment on the lines of basal cell

carcinoma.

CLINICAL FEATURES OF

SQUAMOUS CELL CARCINOMA

It may present in two forms:

An ulcerated growth with elevated &

indurated margins is the common

presentation.

The second form, fungating or

polypoid verrucous lesion without

ulceration, is a rare presentation.

Metastasis: It metastatises in

preauricular & sub-mandibular lymph

nodes.

SQUAMOUS CELL

CARCINOMA

3. Sebaceous gland Carcinoma:

It is a rare tumour arising from the meibomian glands.

TREATMENT:

Surgical excision with reconstruction of lids; recurrences are common.

CLINICAL FEATURES: It usually presents initially as a nodule

(which may be mistaken for a chalazion).Which then grows to form a big growth.

Rarely, a diffuse tumour along the lid margin may be mistaken as chronic blepharitis.

SEBACEOUS GLAND

CARCINOMA

4. Malignant Melanoma

(Melanocarcinoma):

It is a rare tumour of the lid (less than

1% of all eyelid lesions).

It may arise from a pre-existing naevus,

but usually arises from the beginning from

the melanocytes present in the skin.

TREATMENT:

Surgical excision with reconstruction of

lid.

CLINICAL FEATURES OF

MALIGNANT MELANOMA

(MELANOCARCINOMA): It often appears as a flat or slightly

elevated naevus which has variegated

pigmentation & irregular borders.

It may ulcerate & bleed.

Metastasis: The tumour spreads locally

as well as to distant sites by lymphatics &

blood stream.

MALIGNANT MELANOMA