Malignant eyelid tumors are often difficult to diagnose at early stage growth, and can be clinically challenging. Due to the high prevalence of periocular skin cancers, clinicians must be very attentive in their assessment of skin lesions amongst their patients. This case report highlights an early non-healing eyelid lesion transforming into squamous cell carcinoma. An 83-year-old male with no history of malignancy presented with a non-healing and rapidly growing lesion of the left lower eyelid. He first noticed this lesion one-month prior and was treated with oral antibiotics without improvement by his primary care provider. Our slit lamp examination of the left eyelid revealed a large ulcerated mass with white mucoid discharge draining from the center of the lesion. After an oculoplastics referral, the patient was diagnosed with squamous cell carcinoma confirmed by biopsy. Computed tomography(CT) showed no metastasis or invasion to deep layer tissue. The management decision in this case required exenteration of the left eye socket followed by radiation therapy. This case illustrates the clinical course and invasive nature of periocular squamous cell carcinoma. It can present in a variety of different appearances, but are mostly painless, hyperkeratotic lesions that progressively change and ulcerate. An extensive history and careful clinical examination are vital in order to detect malignancy in a timely manner.
SUMMARY The case of an 84‐year‐old woman who experienced musical and visual hallucinations after recurrence of a right occipital meningioma is reported.
Les tumeurs malignes de la paupière sont souvent difficiles à diagnostiquer à un stade précoce et peuvent poser un défi sur le plan clinique. En raison de la prévalence élevée des cancers de la peau périoculaire, les cliniciens doivent être très attentifs dans leur évaluation des lésions cutanées. Un homme de 83 ans sans aucun antécédent de tumeur maligne présentait une lésion non cicatrisante et en croissance rapide de la paupière inférieure gauche. Après une référence en oculoplastique, on a diagnostiqué chez le patient un carcinome spinocellulaire sans métastase ni invasion des tissus de la couche profonde. La prise en charge a nécessité une exentération orbitaire gauche, suivie d’une radiothérapie.
Ce cas illustre l’évolution clinique et la nature invasive du carcinome spinocellulaire périoculaire. Bien que ce carcinome puisse se présenter sous diverses formes, la plupart sont des lésions hyperkératosiques indolores qui évoluent et deviennent progressivement ulcéreuses. Il est essentiel d’avoir des antécédents détaillés et de procéder à un examen clinique minutieux pour détecter la malignité en temps opportun.
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