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There is a great variety of benign growths which may appear on the eyelids. An experienced ophthalmologist is able to identify most of them using biomicroscopy (the slit-lamp). It is important to distinguish between benign and malignant tumours. The most common benign growths on the eyelids are cysts and pigmented tumours. In the immense majority of cases, the formation of a cyst is a sign of benignity. Conversely, a pigmented lesion may be either benign or associated with a malignant tumour.
Benign tumours do not require treatment, but must be monitored regularly by the doctor.
There are 3 main types of malignant tumours of the eyelid:
- Basal-cell carcinoma
- Squamous-cell carcinoma
- Sebaceous carcinoma
Basal-cell carcinoma (BCC) is the most common malignant tumour of the eyelid, accounting for about 85% of all cases. BCC usually affects adults. It is related to exposure to the sun, and the lower lid is most often the one involved.
Metastasis is rarely associated with BCC; the prognosis is usually very good. Treatment relies on complete excision of the tumour, with careful attention to removing all the malignant tissue. Depending on the size of the tumour, various reconstructive techniques will be used to correct the flaw.
Squamous-cell carcinoma is rare, representing only 5% of all eyelid tumours. It is related to exposure to the sun, and usually concerns adult patients.
Squamous-cell carcinoma is more aggressive than basal-cell carcinoma, and more likely to spread.
Sebaceous carcinoma is a cancer of the sebaceous glands of the eyelid. It accounts for up to 5% of all malignant tumours of this area. Most patients are elderly, and women are at a higher risk than men of contracting the disease. Usually, the tumour is located on the upper eyelid. Diagnosis of this carcinoma is still difficult: it is often confused with a benign condition like blepharitis or a chalazion. As a result, it is often diagnosed at an advanced stage, and behaves aggressively.