Eye For God
Bert Bowden, MD
Cosmetic and Reconstructive Eye Surgery

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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 occasionally occur.

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 reconstruction.

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.







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