This study analyzed 164 cases of eyelid malignancies in Bangladesh over 6 years. The most common types were sebaceous gland carcinoma (40.8% of cases), basal cell carcinoma (39.6%), and squamous cell carcinoma (17.6%). Risk factors included prolonged sun exposure and betel nut use. Sebaceous gland carcinoma was more common in the upper eyelid, while basal cell carcinoma was more common in the lower eyelid. Frozen section biopsy was found to be an effective diagnostic and management method. The study highlights that sebaceous gland carcinoma has a higher occurrence in Bangladesh compared to Western countries.

1. Eyelid Malignancies in Bangladesh:
A Clinico-pathologic study
Authors:
Dr Syeed Mehbub Ul Kadir
Dr Golam Haider
Dr Murtuza Nuruddin
Dr Mukti Rani Mitra
BOSS Annual Conference” 2014

2. Disclosure of the Conflict of interest
Dr Syeed Mehbub Ul Kadir
Consultant, Dept of Orbit & Oculoplasty Services
National Institute of Ophthalmology & Hospital
Dhaka, Bangladesh
In relation to this presentation, I declare that
there are no conflicts of interest.

3. Introduction
 Eyelid malignancies are common disorder
 Basal cell Ca. (BCC), Sebaceous gland Ca (SGC) &
Squamous cell Ca are common lid cancer
 It is curable if detected earlier
 Management depends on size, position, type &
invasiveness of the lesion

4. Countries BCC SGC SqCC
Western countries 90-95% 01% 5-10%
India 44.5% 27% 14.8%
Korea 36.8% 42% 10.5%
 Jeong S et al. Extensive destruction of eyeball by invasion of basal cell
carcinoma of the eyelid. Jpn J Ophthalmol. 1998; 43: 300-302
 Jahagirdar SS et al. A clinicopathological study of eyelid malignancies from
central India. 2007; 55: 109-113.

5. Purpose
 The characterize the nature, rate, associated
risk factors and management strategies of
different types of eyelid malignancies in Bangladesh

6. Methods
 Multicentre observational case series study
 2008 to 2013 (6 yrs study)
 Clinically evaluated eyelid malignancies
 We excluded lymphoma, conjunctival & orbital
malignancies involving the eyelid.

7. Methods
 Excision biopsy / frozen section biopsy
 Histopathology confirmed the diagnosis
 Apropriate Reconstruction
 Data collection : Predesigned data- sheet
with Pre & post operative photgraph

8. Results
Type No of Cases Percentage
Basal Cell Carcinoma 65 39.6
Sebaceous Gland Carcinoma 67 40.8
Squamous Cell Carcinoma 29 17.6
Malignant Melonoma 02 1.2
Apocrine Adonocarcinoma 01 0.6
Total 164 100

9. Age distribution
Types ≤ 45 yrs 46-70 yrs ≥ 71 yrs χ² value,
df
P Value
BCC 12% 54% 34% 19.01
SGC 24% 66% 10%
SqCC 07% 52% 41% 08
MM 50% 50% 00
AA 00 100% 00 < 0.05

10. Mean age
Eyelid Malignancies Mean age (yrs)
SGC 56.3 yrs
BCC 60.7 yrs
SqCC 64.1 yrs
MM 52.5 yrs

11. Gender Distribution

12. Associated risk factors
53 %
37 %
23 %
(Prolong sun exposure 30 hrs/wk)

14. Location
Eyelid BCC SGC SqCC
P value
Upper 21% 81% 48%
<0.001
Lower 79% 19% 52%

15.  Orbit : 3.6%
 Lymph node: 7.3%
 Metastatsis: 1.2%

16. Procedure of Surgery
 Excision ē 4 mm normal tissue 86 cases (52.4%)
 Frozen section biopsy 72 cases (44%)
 Exenteration 6 cases (3.6%)

17. Reconstruction No %
Direct Closure 52 31
Semicircular Flap 30 19
Triangular flap 17 10
Cutler beard procedure 18 11
Hughes procedure 23 14
Mastard cheek rotational flap 05 03
Z-Plasty 03 02
Skin graft 16 10

18. Before
Surgery
After

19. Clinical vs Confirmatory diagnosis
Clinical
Dx
BCC SGC SqCC χ²
P value
BCC 63 (94%) 2 2
39.25
SGC 1 64 (97%) 1 < 0.001***
SqCC 1 1 26 (93%)

20. Recurance rate
 1 case after 3 yrs of frozen section biopsy, 1.4%
 5 cases ē in 2 yr of excisional biopsy, 6%

21. Discussion
 A report from USA: BCC-90%, SqCC-
5% & SGC-4% (Holds et al ．２００
８）
 Our study: SGC- 40.8%, BCC- 39.6%
& S ｑ CC-17.6%.
 Age: 34 -100 yrs, > 45 yrs: 85%

22. Discussion
 Betel leaf & nut is common risk factor
 Lower Lid: 79% in BCC
 Upper lid: 81% in SGC
 Metastasis found in SGC
 Frozen section biopsy is better option

23. Take home message
 Sebaceous gland Ca. is highest in occurrence in BD
 Frozen Section is preferred method
 Early Dx & Mx may reduce the ocular morbidity

24. Thank you all
Beautiful Bangladesh