Eyelid Cancer

Overview

Eyelid cancer is a general term for a cancer that occurs on or in the eyelid and is broadly categorized as an epithelial (outer surface) tumor. An eyelid tumor may be benign (noncancerous) or malignant (cancerous, meaning it can spread to other places in the body). A tumor is a mass of tissue created by cells that grow abnormally and without control, and eyelid tumors can begin from sebaceous (fat), sweat, and apocrine glands (a type of sweat gland).

The most common types of cancer occurring on the eyelid are:

Basal cell carcinoma. Under the squamous cells (flat, scale-like cells) in the lower epidermis (outer layer of skin) are round cells known as basal cells. About 80% of skin cancers arise from this layer in skin, and they are directly related to exposure to the sun. Basal cell carcinoma is the most common type of eyelid cancer, usually appearing in the lower lid and occurring most often in individuals with fair or pale skin.

Sebaceous carcinoma. Mostly occurring in middle-age to older adults, sebaceous carcinoma is the second most common eyelid cancer. It may start from meibomian glands (glands of the eyelids that discharge a fatty secretion that lubricates the eyelids) and, less frequently, glands of Zeis (sebaceous glands at the base of the eyelashes). Sebaceous carcinoma is an aggressive cancer that normally occurs on the upper eyelid and is associated with radiation exposure, Bowen’s disease, and Muir-Torre syndrome. A large sebaceous carcinoma, or one that returns after treatment, may require surgical removal of the eye.

Squamous cell carcinoma. The top layer of the epidermis is mostly made up of squamous cells. Approximately 10% to 30% of skin cancers begin in this layer and usually arise from sun exposure, but can also appear on skin that has been burned, damaged by chemicals, or exposed to x-rays. Squamous cell carcinoma is much less common than basal cell carcinoma, but it behaves more aggressively and can more easily spread to nearby tissues.

Melanoma. The deepest layer of the epidermis contains scattered cells called melanocytes, which produce the melanin that gives skin color. Melanoma starts in melanocytes, and it is the most serious of the three skin cancer types.

Symptoms

People with eyelid cancer may experience the symptoms described below. Sometimes people with eyelid cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. If you are concerned about a symptom on this list, please talk with your doctor.

• A change in appearance of the eyelid skin
• Swelling of the eyelid
• Thickening of the eyelid
• Chronic infection of the eyelid
• An ulceration (area where skin is broken) on the eyelid that does not heal
• A spreading, colored mass on the eyelid

Risk Factors

The primary risk factor for eyelid cancer, with the exception of sebaceous gland carcinoma, is excessive exposure to sunlight. Older people are affected more often because they have had more exposure to the sun’s UV rays. Women over age 60 and younger people who have had radiation therapy to the face have the highest risk for sebaceous gland carcinoma. Eyelid cancer is prevalent among people of European descent with fair skin because their skin provides little natural protection against the sun. Hereditary risk factors also may be involved