Eyelid Tumours, classification of tumours with images. Usefull for optometry students.

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

2. 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.

3. CLASSIFICATION
1. 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)

4. 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.

5. SQUAMOUS PAPILLOMAS

6. SEBORRHOEIC KERATOSIS

7. 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.

8. XANTHELASMA

9. 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.

10. CAPILLARY HAEMANGIOMA

11. 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.

12. NAEVUS FLAMMEUS

13. CAVERNOUS HAEMANGIOMA

14. 4. Neurofibroma:
 Lids & orbits are commonly affected in
neurofibromatosis (von Recklinghausen’s
disease).
 The tumour is usually plexiform type.

15. NEUROFIBROMA

16. 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.

17. 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

18. BASAL-CELL CARCINOMA

19. 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.

20. 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.

21. SQUAMOUS CELL
CARCINOMA

22. 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.

23. SEBACEOUS GLAND
CARCINOMA

24. 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.

25. 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.

26. MALIGNANT MELANOMA