Eyelid Skin Cancer & Eyelid Reconstruction
BASAL CELL CARCINOMA (EYELID CANCER)
Basal cell carcinoma is the most common form of skin cancer and the most common eyelid cancer. It
Eyelid Skin Cancer & Eyelid Reconstruction
BASAL CELL CARCINOMA (EYELID CANCER)
Basal cell carcinoma is the most common form of skin cancer and the most common eyelid cancer. It is associated with sun damage and is the least aggressive skin cancer. It is slow growing and does not spread to the rest of the body. While most basal cell carcinomas can be removed with surgery, if left untreated, these tumors can grow around the eye and into the orbit, sinuses and even the brain. Basal cell carcinomas are more commonly found on the lower eyelids and almost never spread to other parts of the body (metastasize).
Sometimes a central ulcer with pearly edges may develop, which does not ultimately heal. If left untreated, it will damage structures in the surrounding area. Treatment is by excision, followed by reconstructive surgery. If small, this may be done with local anesthetic injection. If larger, it is usually performed in a surgery center with local anesthetic and intravenous sedation (sleepy and relaxed but not general anesthetic).
Patients with basal cell carcinomas most commonly notice a reddish nodule slowly forming on their eyelid. The tumor is most commonly found on the lower eyelid, followed by the medial canthus (toward the nose) and can occur on the upper eyelid. Eyelash loss (around the tumor) suggests that a tumor is malignant.
Less commonly, basal cell cancers can be pigmented or are present without any nodule at all. When the tumor does not make a nodule and grows within the eyelid, it can induce pulling of the eyelid (away from the eye). These cases are much more difficult to treat because the edges are harder to define.
A risk factor is anything that increases an individual’s chance of developing cancer. Although certain factors often influence the development of cancer, most do not directly cause cancer. Some people who display multiple risk factors never develop cancer, while others who do not experience any risk factors do. However, knowing your risk factors and discussing them with Dr. Paul will help you make more informed lifestyle and health care choices.
Cancer.net details how the following factors can increase the risk of developing eyelid cancer:
- Exposure to UV radiation: Sunlight includes both ultraviolet A (UVA) and ultraviolet B (UVB) radiation. UVB radiation produces sunburn and plays a role in the development of basal cell carcinoma, squamous cell carcinoma, and melanoma. UVA radiation penetrates the skin more deeply, causing photoaging or wrinkling. The role of UVA radiation in the development of non-melanoma eyelid cancer is suspected, but not certain. People who live in areas with year-round, bright sunlight have a higher risk of developing an eyelid cancer. So do people who spend significant time outside or on a tanning bed, which produces mostly UVA radiation.
- Fair skin: Less melanin (pigment) in skin offers less protection against UV radiation. People with light hair and light-colored eyes are more likely to develop eyelid cancer.
- Age: Most basal and squamous cell cancers appear after the age of 50.
- A history of sunburns or fragile skin: Skin that has been burned, sunburned, or injured from disease is at higher risk for eyelid cancer. Squamous cell and basal cell cancers more often occur with repeated, long-term exposure to the sun. Melanoma more often occurs with short-term intense exposure to sun.
- Individual history: People with weakened immune systems are at higher risk for developing squamous cell and basal cell cancers. People with rare, predisposing genetic conditions such as xeroderma pigmentosum, nevoid basal cell carcinoma syndrome, or albinism are at much higher risk for eyelid cancer.
- Previous skin cancer: People who have had any form of skin cancer are at higher risk for developing another skin cancer. For instance, about 35% to 50% of people diagnosed with one basal cell cancer will develop a new cancer within five years.
- Precancerous skin conditions: Two types of lesions may be related to the development of squamous cell cancer in some people. Actinic keratoses is characterized by rough, red or brown, scaly patches on the skin. Bowen’s disease is characterized by bright red or pink, scaly patches located on previously or presently sun-exposed skin. Bowen’s disease in areas not exposed to the sun may be related to arsenic exposure.
People with eyelid cancer may experience the following symptoms or signs. Sometimes people with eyelid cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer:
- A change in appearance of the eyelid skin
- Swelling of the eyelid
- Thickening of the eyelid
- Chronic infection of the eyelid
- An ulceration (area where skin is broken) on the eyelid that does not heal
- A spreading, colored mass on the