Eyelid Lesion Excision

Eyelid lesions (eyelid lumps and bumps) are very common and can be benign or malignant (cancerous).  Clinical examination and/or biopsy are required for the definitive diagnosis as to whether they are benign or malignant.  There are five main types of benign tumors and five main types of malignant tumors.  There are also rarer tumors.

Benign eyelid lesion

Benign tumors:

  • pigmented lesions
  • benign epithelial tumors
  • pre-cancerous epithelial tumors
  • adnexal and cystic tumors
  • xanthelasma

Maligant tumours:

  • basal cell carcinoma
  • squamous cell carcinoma
  • sebaceous gland carcinoma
  • melanoma
  • lymphoma

Benign eyelid margin lesion

Examination

  • Benign tumors, even though benign, often require removal and therefore must be examined carefully and the differential diagnosis of a malignant eyelid tumor considered and the method of removal planned.  The lesion is examined with respect to its size, shape, color, level in the eyelid, mobility, tethering and tenderness.  The peri-orbital area is examined for additional lesions.
  • If a malignant tumor is suspected, additional evaluation including a full medical examination may be needed and other specialists including an oculoplastic surgeon, dermatologist, oncologist and head and neck surgeon may be consulted in more advanced cases.

Treatment

Malignant eyelid lesion

The majority of small lumps and bumps around the eyelids are benign and can be easily removed in their entirety.  However, even a benign looking lump can be a tumor masquerading as benign and the cells have to be analyzed under the microscope to exclude a malignant tumor (histopathological analysis).

The treatment of eyelid lesions depends on the diagnosis which is obtained by biopsy.  Benign eyelid lesions are excised in full and ocular reconstruction performed using direct closure, flaps or grafts.

Malignant tumors may require adjuvant treatment with either radiotherapy or chemotherapy after excision, depending on their diagnosis.

Surgery of eyelid lumps and bumps can frequently be done under local anesthetic, with the surgeon assisted by magnification, in the form of surgical loops worn on spectacles, in order to place very fine stitches which are almost invisible.

The result of the histological analysis (examination of the cells) is usually available within a week if deemed necessary by the surgeon.