Benign Lesions

The most common benign growths that can occur on the eyelids are chalazia, hordeolae (styes), seborrheic keratosis, papillomas, and nevi. Although these are the most common lesions on the eyelids, there are many other types of benign growths.

1. A chalazion is a painless bump caused by the blockage of an oil gland, resulting in localized swelling and inflammation.

2. A hordeolum, commonly known as a stye, is a tender, red lump that develops when an eyelid oil gland or eyelash follicle becomes infected.

3. Seborrheic keratosis is a benign skin growth that appears as a raised, waxy lesion with a rough or scaly texture.

4. Papilloma are small, harmless growths caused by a viral infection, often characterized by a fleshy or wart-like appearance, but they can be very irritating.

5. Nevi are pigmented moles on the eyelid, which are usually harmless but should be monitored for any changes in size, shape, or color.

While these growths are generally benign, it is essential to consult with a healthcare professional for proper diagnosis and management, as some may resemble or mimic malignant conditions.

Malignant Lesions (Cancer)

The three most common types of cancer that can affect the eyelid are basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and sebaceous gland carcinoma (SGC).

1. Basal cell carcinoma is the most prevalent eyelid cancer and typically develops on the lower eyelid. It usually appears as a pearly or translucent bump and grows slowly.

2. Squamous cell carcinoma often arises on the lower eyelid as well but can occur on the upper eyelid too. It may present as a scaly, red, or crusted lesion that grows more rapidly than BCC.

3. Sebaceous gland carcinoma is a rare but aggressive cancer that originates from the oil glands in the eyelids. It often presents as a hard, painless nodule or thickening of the eyelid skin.

4. Other less common types include: melanoma, merkel cell carcinoma, and others.

Early detection and prompt treatment are crucial for managing eyelid cancers and Dr. Chen and Dr. Pharo are experts in the management of these lesions on the lids and surrounding structures.

How are these tumors treated?

The most important point to understand is that many lesions that appear benign can be malignant and many lesions that appear malignant can be benign. Thus, the most definitive way to identify a lesion is a surgical biopsy, either by removing a small portion of the lesion (INCISIONAL biopsy) or by removing the lesion entirely (EXCISIONAL biopsy).

When you come for your initial consultation, Dr. Chen or Dr. Pharo will evaluate the lesion and discuss with you which approach would result in the most ideal outcome in terms of both function and aesthetics.

That being said, many times with large or very suspicious for cancer lesions, an incisional biopsy is the first step in order to obtain a diagnosis. Should the diagnosis come back as cancerous, Dr. Chen and Dr. Pharo employ the most up to date and appropriate clinical principles in the management of these lesions and utilize a Mohs surgeon to excise the lesion. Once the lesion has been removed by the Mohs surgeon, Dr. Chen and Pharo will reconstruct the eyelid/face, tailoring the technique to size and location of the defect.

Mohs surgery, also known as Mohs micrographic surgery, is a specialized and precise surgical technique used to treat certain types of skin cancer, primarily basal cell carcinoma and squamous cell carcinoma. It involves the systematic removal and examination of layers of skin until the entire tumor is completely removed, while sparing as much healthy tissue as possible. During the procedure, the surgeon removes a thin layer of skin and immediately examines it under a microscope. If cancer cells are detected at the margins, another layer is removed and examined, repeating the process until clear margins are achieved. This process ensures maximum preservation of healthy tissue and minimizes the chance of cancer recurrence. Mohs surgery is particularly beneficial for skin cancers located in areas where tissue preservation is critical, such as the eyelids, nose, ears, and lips. The procedure is performed by a specially trained dermatologist, called a Mohs surgeon, ensuring optimal outcomes.