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Ophthalmology

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Eyelid

Question
17 out of 17
 

Most common malignant tumour of Eye lid. (AIIMS Nov 2009)



A Sebaceous Ca

B BCC

C SCC

D Malignant melanoma

Ans. B Basal cell carcinoma

(Reference: Kanski: Clinical ophthalmology Edition 6, Page 109,110,111)

1. BCC is the commonest human malignancy and typically affects elderly patients.

2. Important risk factors are fair skin, inability to tan and chronic exposure to sunlight. 90% of cases occur in the head and neck and about 10% of these involve the eyelid.

3. The tumor is slow growing and locally invasive but non-metastasizing.

4. Tumours located near the medial canthus are more prone to invade the orbit and sinuses, and are more difficult to manage than those arising elsewhere and carry the greatest risk of recurrence.

5. Tumors that recur following incomplete treatment, tend to be more aggressive and difficult to treat.

6. Squamous cell carcinoma is a much less common, but potentially more aggressive tumor than BCC with metastasis to regional lymph nodes in about 20% of cases.

7. Careful surveillance of regional lymph nodes is therefore and important aspect of initial assessment.

8. The tumor may also exhibit peri neural spread to the intracranial cavity via the orbit.

9. SCC accounts for 5-10% of eyelid malignancies and may arise de novo or from pre existing actinic keratosis or carcinoma in situ Bowen disease.

10. Immuno compromised patients with AIDS and those with renal transplants are at increased risk.

11. Sebaceous carcinoma are located in the periocular skin, the caruncle and eyebrow skin follicles.

12. SGC is a very rare slow growing tumor which most frequently affects the elderly, with a predisposition for females.

13. It usually arises from the meibomian glands, although on occasion it may arise from the glands of zeis or sebaceous glands in the caruncle.

14. In contrast to BCC and SCC, the tumor occurs more commonly on the upper eyelid where meibomian glands are more numerous.

15. Melanoma rarely develops on the eyelids but is potentially lethal. Although pigmentation is a hallmark of skin melanomas, half of lid melanomas are nonpigmented and this may give rise to diagnostic difficulties

Eyelid Flashcard List

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