This document discusses different types of eyelid tumors. It first separates tumors into benign and malignant categories. Common benign tumors include papillomas, xanthelasma, hemangioma, and neurofibroma. The most frequent malignant tumors are basal cell carcinoma, squamous cell carcinoma, sebaceous gland carcinoma, and malignant melanoma. For each tumor type, the document describes characteristics such as appearance, patient demographic, treatment options, and clinical features.

1. EYELID TUMOURS
-SOLANKI RIDDHI
2ND YEAR (B.OPTOM)

2. Almost all types of tumours arising
from the skin, connective tissue,
glandular tissue, blood vessels,
nerves & muscles can involve the lids.
A few common tumours are listed
here.

3. CLASSIFICATION
1. BENIGN TUMOURS
1. Papillomas
2. Xanthelasma
3. Haemangioma
4. Neurofibroma
2. MALIGNANT TUMOURS
1. Basal-cell Carcinoma
2. Squamous cell Carcinoma
3. Sebaceous Gland Carcinoma
4. Malignant Melanoma (Melanocarcinoma)

4. 1. BENIGN TUMOURS
1. Papillomas:
These are the most common benign
tumours arising from the surface epithelium.
i. Squamous papillomas occur in adults, as
very slow growing or stationary, raspberry-
like growths or as a pedunculate lesion,
usually involving the lid margin.
ii. Seborrhoeic keratosis occurs in middle-
aged & older persons. Their surface is
friable, verrucous & slightly pigmented.
TREATMENT:
Simple excision.

5. SQUAMOUS PAPILLOMAS

6. SEBORRHOEIC KERATOSIS

7. 2. Xanthelasma:
 These are creamy-yellow plaque-like
lesions which frequently involve the skin of
upper & lower lids near the inner canthus.
 Xanthelasma represents lipid deposits in
histiocytes in the dermis of the lid.
 These may be associated with diabetes
mellitus or high cholesterol levels.
TREATMENT:
Excision may be advised for cosmetic
reasons; but recurrences are common.

8. XANTHELASMA

9. 3. Haemangioma:
Haemangiomas of the lids are common
tumours.
i. Capillary haemangioma:
 Is the most common variety which
occurs at or shortly after birth, often grows
rapidly & in many cases resolves
spontaneously by the age of 7 years.
 These may be superficial & bright red in
colour or deep & bluish or violet in colour.
 They consists of proliferating capillaries
& endothelial cells.
TREATMENT:
Excision, Intralesional steroid,
Superficial radiotherapy.

10. CAPILLARY HAEMANGIOMA

11. ii. Naevus flammeus (port wine stain):
 It may occur side-by-side or more
commonly as a part of Sturge-Weber
syndrome.
 It consists of dilated vascular channels &
does not grow or regress like the capillary
haemangioma.
iii. Cavernous haemangioma:
 Are developmental & usually occur after
first decade of life.
 It consists of large endothelium-lined
vascular channels & usually does not show
any regression.

12. NAEVUS FLAMMEUS

13. CAVERNOUS HAEMANGIOMA

14. 4. Neurofibroma:
 Lids & orbits are commonly affected in
neurofibromatosis (von Recklinghausen’s
disease).
 The tumour is usually plexiform type.

15. NEUROFIBROMA

16. 2. MALIGNANT TUMOURS
1. Basal-cell Carcinoma:
 It is the commonest malignant tumour of
the lids (90%) usually seen in elderly
people.
 It is locally malignant & involves most
commonly lower lid (50%) followed by
medial canthus (25%), upper lid (10-15%)
& outer canthus (5-10%).
TREATMENT:
Surgery, Radiotherapy & Cryotherapy.

17. CLINICAL FEATURES OF BASAL-
CELL CARCINOMA
It may present in four forms:
 Noduloulcerative basal cell carcinoma is
the most common presentation.
 It starts as a small nodule which
undergoes central ulceration with pearly
rolled margins.
 The tumour grows by burrowing &
destroying the tissues locally like a rodent &
hence the name rodent ulcer.
 Other rare presentations include: non-
ulcerated nodular form, sclerosing or
morphea type & pigmented basal cell

18. BASAL-CELL CARCINOMA

19. 2. Squamous cell Carcinoma:
 It forms the second commonest
malignant tumour of the lid.
 Its incidence (5%) is much less than the
basal cell carcinoma.
 It commonly arises from the lid margin
(mucocutaneous junction) in elderly
patients.
 Affects upper & lower lids equally.
TREATMENT:
Treatment on the lines of basal cell
carcinoma.

20. CLINICAL FEATURES OF
SQUAMOUS CELL CARCINOMA
It may present in two forms:
 An ulcerated growth with elevated &
indurated margins is the common
presentation.
 The second form, fungating or
polypoid verrucous lesion without
ulceration, is a rare presentation.
 Metastasis: It metastatises in
preauricular & sub-mandibular lymph
nodes.

21. SQUAMOUS CELL
CARCINOMA

22. 3. Sebaceous gland Carcinoma:
 It is a rare tumour arising from the
meibomian glands.
TREATMENT:
Surgical excision with reconstruction of
lids; recurrences are common.
CLINICAL FEATURES:
 It usually presents initially as a nodule
(which may be mistaken for a chalazion).
Which then grows to form a big growth.
 Rarely, a diffuse tumour along the lid
margin may be mistaken as chronic
blepharitis.

23. SEBACEOUS GLAND
CARCINOMA

24. 4. Malignant Melanoma
(Melanocarcinoma):
 It is a rare tumour of the lid (less than
1% of all eyelid lesions).
 It may arise from a pre-existing naevus,
but usually arises from the beginning from
the melanocytes present in the skin.
TREATMENT:
Surgical excision with reconstruction of
lid.

25. CLINICAL FEATURES OF
MALIGNANT MELANOMA
(MELANOCARCINOMA):
 It often appears as a flat or slightly
elevated naevus which has variegated
pigmentation & irregular borders.
 It may ulcerate & bleed.
 Metastasis: The tumour spreads locally
as well as to distant sites by lymphatics &
blood stream.

26. MALIGNANT MELANOMA