This article will talk about the different types of eyelid cancer, including symptoms, diagnosis, treatment, and prevention tips.
Eyelid cancer is a type of cancer that affects the skin or glands of the eyelid. The eyelids are composed of four layers:
- skin and subcutaneous tissue
- striated muscle
- meibomian glands
- palpebral conjunctiva
Tumors of the eyelid are classified according to their tissue or cell of origin. Eyelid tumors can either be benign or malignant. Eyelid tumors account for 5–10% of all skin cancers. Basal cell carcinoma is the most common type of malignant growth.
In early stages, eyelid cancer may not have obvious symptoms. Common eyelid cancer symptoms include:
- broken skin, lesion, or sore on the eyelid that does not heal
- changed appearance, such as thickening or color changes of the eyelid skin
- swelling of the eyelid
- losing eyelashes
- a red, black, or brown bump on the eyelid, especially if it is growing or changing
- a chronic eyelid infection
- inflammation of the eyelid, resembling blepharitis
- dropping, bulging, or swollen eye
There are several different types of eyelid cancer, each with its own symptoms and causes. Types of eyelid cancer include:
- basal cell carcinoma
- sebaceous gland carcinoma
- squamous cell carcinoma
- Merkel cell carcinoma
- melanoma
Basal cell carcinoma is the most common type of eyelid cancer, accounting for 85–95% of all eyelid cancers. The main cause is UV radiation, although it may also have a hereditary component. It is most common in people with fair skin.
Basal cell cancer typically appears on the lower lid near the inner or outer part of the eye. It is less common on the upper lid.
The tumor usually has a raised, ulcerated surface with pearly white margins. Although it rarely metastasizes, it can recur. When found early, this type of eyelid cancer is highly treatable.
Read more details about basal cell carcinoma.
Sebaceous gland carcinoma is a rare type of eyelid cancer. It is considered aggressive because of its ability to spread. It typically appears as a firm, round tumor on the lower or upper eyelid. It is usually not painful.
When it is found early, treatment is often successful. Like basal cell cancer, this type is usually caused by exposure to UV light and occurs most commonly in people with fair skin.
Sebaceous gland tumors account for only 5% of all eyelid malignancies.
Squamous cell cancer is a slow growing eyelid cancer that is also caused by exposure to UV rays in people with fair skin. About 5% of all eyelid malignancies are squamous cell cancer.
Squamous cells are found throughout the body. On the skin, it is their job to protect the underlying tissues. This type of cancer typically does not spread, but if it does, it spreads to the deeper layers of the skin.
Squamous cell cancer typically appears as a nonhealing sore on the eyelid.
Learn more about squamous cell carcinoma.
Rhabdomyosarcoma is a type of soft tissue cancer that affects the muscles, tendons, and nerves around the eye. It mostly affects young children, but it can also appear in babies and older people.
Symptoms of this type of cancer include a drooping eye, bulging of the eye, or a swollen eye.
Rhabdomyosarcoma is rare, but it needs to be treated with surgery, chemotherapy, radiation, or a combination of these. Outcomes are best when the cancer is treated in the early stages.
Merkel cell carcinoma is another rare type of cancer that can affect the eyelid. It occurs in people with fair skin with frequent sun exposure. Records indicate that Merkel cell cancer was diagnosed in only 2,000 people in the United States in 2018. However, it is now occurring with increased frequency.
Merkel cell carcinoma can appear as and be mistaken for a stye, cyst, pimple, or sore.
Merkel cell carcinoma is considered aggressive because it has a tendency to spread to other areas of the body. It can also return after treatment. People over age 50 are more likely to develop this type of cancer than those of younger ages.
Read more about Merkel cell carcinoma.
Melanoma is a type of cancer that starts in cells called melanocytes. Melanocytes are cells that make pigment in the skin, lips, and lining of the organs.
Melanoma of the eyelid is very rare, accounting for less than 1% of all cutaneous malignant melanomas. Treatment typically involves surgery or radiation.
Like the other type of eyelid cancers, it is usually caused by frequent exposure to UV radiation, either through direct sunlight or tanning beds.
The most common site for eyelid melanomas is the lower eyelid. They can arise from preexisting moles.
Read more details about melanoma.
The stages of eyelid cancer depend on the size of the tumor and whether malignant cells have spread to other areas of the body. The stages include:
- Stage 0: This is called carcinoma in situ, which is a tumor that has not spread outside its original site.
- Stage IA: The tumor is 5 millimeters (mm) or smaller in diameter, or the tumor has not invaded the connective tissue that supports the eyelid, nearby lymph nodes, or other body areas.
- Stage IB: The tumor is 5–10 mm in diameter, or it has invaded the connective tissue that supports the eyelid. The tumor has not spread to nearby lymph nodes or to other body areas.
- Stage IC: The tumor is 10–20 mm in diameter or has spread into the full thickness of the eyelid, but it has not spread to the lymph nodes or other areas in the body.
- Stage II: The tumor is larger than 20 mm in diameter or has spread to nearby parts of the eye, but it has not spread to the lymph nodes or another body area.
- Stage IIIA: The tumor is large enough that the surgeon may need to remove the eye and nearby structures to get rid of the tumor. However, it has not spread to the lymph nodes or other areas of the body.
- Stage IIIB: The tumor is of any size and has spread to the nearby lymph nodes, but not to other areas of the body.
- Stage IIIC: The tumor has spread outside the eye, with or without spreading to the regional lymph nodes. It cannot be surgically removed because of extensive invasion in nearby eye structures. The tumor has not yet spread to distant parts of the body.
- Stage IV: A tumor of any size that has spread to distant areas of the body.
The most common cause of eyelid cancer is exposure to UV radiation, either through direct sunlight or tanning beds, without proper protective skin coverings.
Most eyelid cancers are more common in older adults and those who have fair skin or a lot of freckles.
Having an HIV or HPV infection places you more at risk for developing squamous cell carcinoma.
Melanoma is more likely to occur in people with irregularly shaped moles or those who have an inherited cancer syndrome.
You should see a doctor if you notice a bump on your eyelid that does not go away on its own.
Eyelid tumors aren’t typically painful, and you may have no other symptoms besides the bump on your eyelid.
See a doctor or dermatologist if you have:
- any moles on your eyelid that are of an irregular shape or color
- any other eye symptoms, such as drooping, bulging, or swelling of the eye
Doctors diagnose eyelid cancer by performing a thorough eye exam.
Your doctor may also order imaging and tests, including:
- an ultrasound of the eye to see a picture of the inside of your eye
- a fluorescein angiography to view the blood vessels in your eye
- a biopsy of the eyelid tumor to test for cancer cells
- blood tests to check your overall health and the numbers and types of cells in your blood
Treatment for eyelid cancer usually involves chemotherapy, radiation, surgery, or a combination of these.
Your treatment will depend on the type of eyelid cancer you have and several other factors. Factors influencing treatment include the size of the tumor and whether cancer cells have spread to the lymph nodes or other areas of the body.
Chemotherapy for eyelid cancer
Chemotherapy uses powerful medications to destroy cancer cells. It may be in the form of an intravenous solution or eye drops. Chemotherapy is typically done in an outpatient clinic, at home, or sometimes overnight in a hospital. Chemotherapy may not help with all types of eyelid cancer.
Radiation for eyelid cancer
Radiation uses high-energy waves to kill cancer cells and only targets the treatment area. Radiation can be used to treat many different types of eyelid cancer. Radiation can be delivered internally, coming from inside the eye, or externally, coming from outside the eye.
Surgery for eyelid cancer
Surgery for eyelid cancer may involve removing part of the eye or surrounding structures. In some severe cases, it is necessary to remove the entire eye.
A less invasive type of surgery is called Mohs surgery. This involves removing the cancer while sparing as much surrounding healthy tissue as possible.
The best way to prevent eyelid cancer is to stay out of the sun and avoid tanning beds. If you do have to be in the sun, wear sunglasses and sunscreen on your face to protect your eyes.
Regularly examine the skin around your eyes for any unusual looking moles, sores, skin changes, or shedding eyelashes. It’s also important to get an eye exam once a year to detect any changes in your eyes.
The most common complication of eyelid cancer is spread to:
- nearby lymph nodes
- deeper layers of the skin
- distant parts of the body
However, this is rare with eyelid cancer. The more aggressive types of eyelid cancers, such as Merkel cell and sebaceous gland cancers, are more likely to spread than other types. Some eyelid cancers can also recur after treatment.
Some types of eyelid cancers are more serious than others because of their ability to spread to other areas and come back after treatment. Overall, when eyelid cancer is found early, there are better treatment outcomes. Most types of eyelid cancer can be treated successfully with early diagnosis.
Eyelid cancer involves cancerous cells or tumors on the eyelid. There are several types of eyelid cancer, most of them caused by exposure to UV radiation. Eyelid cancer is more common in older adults and people with fair skin.
Eyelid cancer can arise from preexisting moles that are of an irregular shape or color. This type of cancer is typically treated with a combination of chemotherapy, radiation, and/or surgery.
The most common complication of eyelid cancer is the spreading of cancer cells to other areas of the body.
