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Cancer of the Eyelid
There are many cancers of the eyelid skin that can occur. The most common
of these is a "benign" malignancy known as a basal cell carcinoma.
Basal cell carcinoma begins as a small growth and increases in size.
Typically, the edges of it are somewhat pearly and there is usually a
central hole from which it may bleed. If the carcinoma involves the
eyelashes, typically the eyelashes are absent in this area. Of course, a
benign lesion would not destroy eyelashes.
There are other cancers that can occur on the eyelid, including squamous
cell carcinoma and melanoma. These are very unusual cancers, but they do
In most of these cancers, they are simply locally invasive. They only, in
very rare circumstances, spread to the eye, to the lymph nodes, or to the
bloodstream. If left alone, they will only increase in size and destroy
tissue locally. For this reason, they should be removed quickly when they
are small in order to achieve the easiest and most pleasing cosmetic
Typical reconstruction of these carcinomas first involves removal of all
of the cancer from the eyelid. The removal of the cancer may be done in
many different ways and may involve a complete removal of a portion of
the eyelid. Once all the cancer is gone, then attention must be directed
to the reconstruction of the eyelid. The eyelid must be returned to its
proper structure and function. This may involve restoring the
windshield-wiper effect of the eyelids or it may involve replacement of
the tear drainage system.
The last step in any reconstruction involves considering the cosmetic
aspect of the reconstruction. Without removing the carcinoma, and
restoring the function, making it look good doesn't make sense.
Occasionally, we will take the patient to the hospital for actual removal
of the cancer in the operating room so that the pathologists can evaluate
it immediately. They will examine this under what is called frozen
section examination. They can determine adequately at this point that
there is no more cancer and, and then reconstruction may be undertaken.
Should you have one of the cancers of the eyelid, Dr. Bowden will discuss
with you the proper methods of removal and reconstruction for you.