Malignancies of the eyelid: a review of primary and metastatic cancers

Abstract

The eyelid can be the site of various malignant tumors, including epithelial, mesenchymal, lymphoproliferative, and endocrine neoplasms, all of which can present in unusual ways or mimic benign processes, often requiring biopsy for a definitive diagnosis. This review article presents a broad overview of some of the malignancies that have been reported to occur in eyelids, addressing clinical presentation and natural history, histologic and immunostaining characteristics, and genetic associations where relevant. The unique combination of functional importance, to protect and lubricate the eye, and cosmetic importance make management of eyelid lesions difficult. We describe a few of the diagnostic and treatment options that can be considered.

Self-healing Eyelid Nodule: A Quiz

“…Three of them showed simultaneous lesions over their head, neck, trunk, and limbs (6,9,10) while the rest consisted of solitary eyelid LyP lesions characteristically accompanied by a previous or subsequent history of several waxing and waning necrotic papulonodules (5,7,8), as we noticed in our patient. This important finding is probably the most helpful clinical trait to consider LyP when atypical single presentations appear, differentiating it from cALCL and other much more common and aggressive papulonecrotic eyelid proliferations, such as keratoacanthoma and squamous cell carcinoma (2).…”

“…Along with cutaneous anaplastic large cell lymphoma (cALCL), LyP belongs to the continuous spectrum of cutaneous CD30 + lymphoproliferative disorders, the second most common group of primary cutaneous T-cell lymphomas (CTCL). Originally described by Macaulay (1) as a "self-healing, rhythmic and paradoxical eruption, histologically malignant but clinically benign", it is currently well known that LyP is a relapsing but indolent skin disease that may be histologically indistinguishable from aggressive cutaneous lymphocytic proliferations (2)(3)(4)(5)(6)(7)(8)(9)(10). Achieving an accurate clinicopathological correlation is therefore absolutely mandatory for a conclusive diagnosis.…”

“…Clinically, LyP is characterised by outbreaks of papular or nodular lesions that usually become necrotic and typically heal spontaneously within a few weeks leaving an atrophic or hypopigmented scar (1)(2)(3)(4)(5)(6)(7)(8)(9)(10). Although this entity may be easily confused with other skin diseases such as arthropod-bites, prurigo, pyodermas, pityriasis lichenoides, or even cutaneous malignancies, its chronic recurrent course and especially its self-healing nature are both the differential clinical clues.…”

“…To date, 5 histopathological subtypes of LyP, respectively named from A to E, have been defined (2)(3)(4)(5)(6)(7)(8)(9)(10). Overlapping patterns in the same specimen or in the same patient are observed in up to 10% of skin biopsies generally between the types A and C, the most common variants of LyP.…”

Adverse effect of UV radiation on eyes — a review

“…The most common malignant carcinoma of the eyelids is basal cell carcinoma (BCC) (86-96% of cases), the second common is squamous cell carcinoma (SCC) (4.4-12.6% of cases) [7]. Both types of cancer are an effect of accumulated damages of DNA caused by sun exposure [8]. There is a dependence between latitude and incidence of BCC and SCC.…”