A Clinical study on Prevalence and Management of Eyelid Tumours

INTRODUCTION: Eyelid tumours are the most common neoplasms encountered in ophthalmic practice. These lesions may arise from the epidermis, dermis or adnexal structures. Malignancies in the eyelid account for 5-10% of all skin cancers. Certain peculiar features such as localized loss of lashes, distortion of eyelid margin, effacement of orifices may be suggestive of malignancy. Most of the benign tumours of the eyelids requires simple excision. After histopathological examination, malignant tumours are managed by wide local excision with 4-5 mm margin clearance followed by eyelid reconstruction. AIM OF THE STUDY: 1. To study the incidence of eyelid tumours. 2. To analyse the treatment modalities available for eyelid tumours. MATERIALS AND METHODS: Detailed history including the onset, duration, progression, associated features such as pain, discharge or bleeding from the lesion, site of involvement, history of co morbidities, past history of medical and surgical treatment were noted. Ocular examination including size, shape, location, extent, margins of the ulcer/swelling and lymph node examination was done. Routine investigations like blood pressure, blood sugar, complete blood count, X-ray chest and X-ray orbit was performed in patients eyelid tumours. For larger lesions or if globe/orbital infiltration is suspected, CT scan brain and orbit was done. Biopsy either excision or incision was done for all the tumours and sent for histopathological examination. After HPE confirmation of malignant tumours wide local excision with 4-5 mm margin clearance was done. Defect in the eyelid was reconstructed using appropriate reconstruction procedure. Patients with globe and orbital invasion were referred to tumour board and destructive procedure like exenteration was done after getting clearance. Patients who required adjuvant radiotherapy or chemotherapy were referred to the department of oncology. All patients were followed up at regular intervals to look for tumour recurrence for One year. RESULTS: Among 40 cases, Benign tumours are more commonly seen than malignant tumours. The most common benign tumour in our study was squamous papilloma (25%) followed by pyogenic granuloma and sebaceous cyst. Among malignant tumours sebaceous gland carcinoma (58.33%) ranks the first and this is followed by basal cell carcinoma. All the benign tumours required excision and for malignant tumours, wide local excision with 4-5 mm margin clearance followed by lid reconstruction was done. Both functional and cosmetic outcome was good postoperatively. CONCLUSION: Histopathologic examination of all excised lesion must be done as an innocuous looking lesion might be malignant. Early clinical diagnosis of malignant tumours with confirmation by incision biopsy, will aid in complete wide excision of tumour and good functional and cosmetic outcome