Clinical Characteristics and Outcome of Malignant Eyelid Tumors: A Five-Year Retrospective Study

Abstract

Introduction: To the best of our knowledge, this is the first study about malignant eyelid tumors in the region of Tuzla, Bosnia and Herzegovina, and it shows similar results comparing with other countries (the annual incidence of eyelid tumors in Tuzla region is about 3.73/100 000 population). Malignant eyelid tumors are relatively uncommon, but potentially fatal disease. However, if detected early and treated adequately, the prognosis is generally excellent. Aim: The aim of this study was the clinical and microscopical analysis of malignant eyelid tumors in treated patients, the presentation of surgical treatment and reconstructive methods of eyelid tumors. Methods: This retrospective study included 60 patients surgically treated at the University Clinical Center Tuzla from January 2012 to December 2016, who were initially diagnosed with malignant eyelid tumors in accordance to the final results obtained by histological examination of excised lesions. Results: In the group of malignant tumors, the most common tumors were BCC (85%), which were predominantly found on the lower eyelids (92.16%) and showed female predominance (51.06%). SCC was the second most common eyelid malignancy (15%) and showed a predilection for the lower eyelid involvement and male predominance (55.56%). Tumors up to 2 cm in diameter (clinical stage T1) were found in 78.33% of cases, 95.74% of which with radical excision, while 4.26% with non-radical excision. Conclusion: Treatment by complete excision with histological confirmation of tumor clearance is recommended. Perineural spread is an adverse prognostic sign, which may require postoperative radiotherapy. Orbital invasion is a rare complication but, if recognized early, it can be treated effectively with exenteration. Because presentation varies and histological examination is required for accurate diagnosis, any suspicious lesion occurring on the eyelids should be excised or biopsied. All patients with malignant tumors should be advised of the risk of recurrent or new tumors and encouraged to attend lifelong follow up.

Evaluation of the Eyelid and Periocular Tumors

“…Although there was no statistically significant difference between lower and upper eyelids in malignant, benign or premalignant lesions, we noted that BCC predominantly located in lower eyelid similar to some studies (9,12,15).…”

Noninvasive identification of Benign and malignant eyelid tumors using clinical images via deep learning system

“…Supporting the literatures, malignant eyelid tumors developed at an elder age than the benign tumors [2,54,55]. Similar to some previous studies, we also observed a lower eyelid predominance for the malignant eyelid tumors [9,56]. Prolonged exposure to sunlight seems to be an important predisposing factor of this predominance [57].…”

Metabolic signature of eyelid basal cell carcinoma

“…Basal cell carcinoma (BCC) is the most common eyelid malignancy, accounting for 85-95% of all eyelid cancers (Silverman and Shinder, 2017;Yin et al, 2015). Usually located at the lower eyelid and medial canthal region, BCC rarely metastasizes, but it can locally invade into the orbit, sinuses, and brain to cause tissue destruction (Burgic et al, 2019). Although surgical resection with histologic control of margins is the preferred treatment for BCC (Margo and Waltz, 1993), radiation and cryotherapy are commonly used when surgery is not appropriate.…”