Eyelid tumours

One of the commonest eyelid problems that oculoplastic surgeons see and treat is the eyelid tumour. 

A tumour is any abnormal growth and can be benign or malignant.

A benign tumour does not invade the local eyelid tissue nor does it spread to other parts of the body. Examples of common benign eyelid tumours  are seborrhoeic keratosis (or"senile wart") and intradermal naevus.

A malignant tumour (or cancer) can invade and destroy the surrounding eyelid tissues. 

The vast majority of eyelid cancers (more than 90%) are basal cell carcinomas (BCC or "rodent ulcer") which only very rarely spread to other parts of the body (metastasise). However, they do need to be treated to prevent them from destroying the eyelid and surrounding structures.

If there is some doubt about the diagnosis then it is important to take a sample of the lesion (an incisional biopsy) to obtain a diagnosis. The pathologist will view the specimen under a microscope. Once the diagnosis is confirmed then appropriate treatment can be planned.

Treatments for Eyelid Tumours 

The best way to treat a BCC is to remove it entirely, confirm it has all been removed and then plan to repair the  the eyelid to give the best functional and cosmetic result possible.

The gold standard (best) treatment for eyelid (periocular) BCCs is Mohs' micrographic surgery.

The Mohs' surgeon is a consultant dermatologist who has specialist training to remove a skin cancer with a special technique (Mohs' surgery) and check under the microscope that all the cancer has been removed. If need be the Mohs' surgeon can go back and remove some more until all the cancer has been removed but as much as possible of the normal skin has been left intact. 

Mohs' surgery is particularly valuable for eyelid cancers where it is crucial to leave as much normal eyelid as possible yet remove the cancer in it's entirety.

Mohs' surgery has the best cure rate of all techniques (for BCC there is a 99% 5 year cure rate ie. 99% of patients will have no recurrence of the tumour within 5 years of treatment).

Rarer (but often more aggressive) malignant eyelid tumours include squamous cell carcinomas (SCC), sebaceous gland carcinomas (SGC), Merkel cell carcinomas and melanomas.

Your consultation

The success and safety of your eyelid surgery procedure depends very much on your complete candidness during your cosmetic eyelid surgery consultation. You'll be asked a number of questions about your health, desires and lifestyle.

Please be prepared to discuss:

• Why you want the surgery, your expectations and desired outcome
• Medical conditions, drug allergies and previous medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol & tobacco
• Previous surgeries

The following will also take place at your consultation

• Evaluation of your general health and any pre-existing health conditions or risk factors
• An assessment of your vision and a thorough eye examination including a slit-lamp examination of the eye.
• Photographs for your medical record
• A discussion about treatment options
• Recommendations for treatment most appropriate for you
• Discussion about likely outcomes of eyelid surgery and risks or potential complications
• The type of anaesthesia that will be used (This is usually “Twilight anaesthesia” using local anaesthesia with intravenous sedation administered by a consultant anaesthetist. However, a full general anaesthetic can be arranged if you prefer this option)

After the consultation I will send you a letter summarising your concerns and desires relating to your appearance along with my assessment and advice to you regarding treatment options.

You will also receive a quote for your proposed surgery and have the opportunity to attend for a further consultation prior to proceeding should you wish to ask any further questions.

Arrange a consultation