Eyelid Cancers

Eyelid malignancies account for approximately 10% of all skin cancers.  Although they are seldom fatal,  they can lead to significant tissue damage and may spread to other orbital and facial structures.  Eyelid cancers are most prevalent in light-skinned individuals who have experienced significant sun exposure over time, and they also occur most frequently on the lower eyelid.  Basal cell carcinomas account for approximately 90% of all eyelid cancer cases, Squamous cell carcinomas occur approximately 5% of the time and melanoma, one of the most dangerous forms, accounts for approximately 1-2% of cases.  Other rare carcinomas such as sebaceous cell and Merkel cell are also possible in the eye area.  

Basal cell carcinoma (BCC) develops in the basal cells within the epidermis (top layer) of the skin. Basal cell carcinoma is the most common type of skin cancer of the eyelids and accounts for approximately 90% of all eyelid cancer cases.  The most prevalent cause of basal cell carcinoma is prolonged exposure to UV rays of the sun.  They usually develop as small, firm, painless nodules with a smooth, pearly appearance.  They may also develop telangiectasia (a reddish color as a result of dilated capillaries). 

Basal cell carcinomas rarely metastasize to lymph nodes or distant organs, but they are still considered malignant.  If they are not detected and treated early, then they can cause local destruction of surrounding tissues including the eye, the orbital cavity and the nasal cavity.  Basal cell carcinomas are often treated by removing the tumor via Mohs micrographic surgery.  Based on the size of the excision, scars are minimized via reconstruction of the affected area. 

Squamous cell carcinoma is a more aggressive form of skin cancer that develops in the squamous cells of the epidermis (top layer of the skin).  Squamous cell carcinomas occur most frequently in areas that are subjected to prolonged exposure to the sun's harmful UV rays.  In the eye area, squamous cell carcinomas usually occur on the eyelids and look like raised, scaly patches of reddened skin that may resemble a scab that does not heal.  They are more dangerous than basal cell carcinomas in that they can metastasize to lymph nodes and distant organs, so early detection and treatment is important.  If a squamous cell carcinoma develops, then removal of the tumor and the surrounding tissues via Mohs micrographic surgery is the primary treatment.   

Melanoma is a more serious type of skin cancer because it often metastasizes to lymph nodes and distant organs versus other types of skin cancer.  Melanoma begins in melanocytes, the cells that produce pigment in the skin, eyes and hair. While melanoma can occur in any area where melanocytes are found, most melanocytes are present in the skin, making it the most common form of the disease.   Early detection of melanoma is important, as the survival rate is very high if detected before it spreads to other organs.  Once detected, a team of doctors will work with you to determine the best course of treatment.  For more information, go to www.melanoma.org.  

Sebaceous cell carcinoma is a rare form of cancer of the eyelids often mistaken for benign conditions such as a sty or chalazion (a small bump on the eyelid caused by a blockage of an oil gland), as the tumors originate from the glands in the eyelid that produce the oily layer of tears. Any "sty" or chalazion that does not resolve within several weeks to months must be evaluated to rule out a possible sebaceous cell carcinoma. The treatment consists of surgical removal and monitoring to ensure distant metastasis does not occur.
 
Merkel cell carcinoma or MCC is a rare but aggressive skin cancer that arises from the uncontrolled growth of Merkel cells in the skin. . MCC has the potential to be lethal, and thus prompt, aggressive treatment is important. For more information, go to www.merkelcell.org.  

As an ophthalmologist and oculoplastic surgeon, Dr, Elahi specializes in detecting and treating cancers surrounding the eye area.  He also works closely with a team of highly regarded dermatologic surgeons, oncologists and other surgeons when more aggressive treatments are indicated.