SpringerLink
Log in

Upper and Lower Eyelid Malignancies: Differences in Clinical Presentation, Metastasis, and Treatment

  • REVIEW
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Approximately 5–15% of all dermatologic malignancies manifest in the upper and lower eyelids. The primary types include basal cell carcinoma, squamous cell carcinoma, and sebaceous cell carcinoma, with Merkel cell carcinoma and melanoma following closely behind. Basal cell carcinoma predominantly affects the lower eyelid, yet various other carcinomas, melanomas, metastases, and neoplasms of diverse origins can arise on both upper and lower eyelids. Risk factors such as advanced age, smoking, and notably, exposure to UV light significantly contribute to the development of these eyelid lesions. Despite the increasing incidence, research on dermatologic eyelid malignancies remains limited. However, such study is imperative given that many systemic oncologic malignancies initially present as metastatic eyelid lesions. This paper provides an in-depth exploration of eyelid anatomy, clinical presentation, diagnosis, and treatment management.

Key Points:

  • Eyelid metastases represent less than one percent of all eyelid cancers, yet they often serve as the initial indication of an underlying systemic malignancy.

  • Early detection and treatment is crucial in improving prognosis and quality of life for patients.

  • Treatment options encompass a range of modalities, with Mohs surgery as the gold standard for the removal of ocular tumors.

  • Additional treatment options include local excision as well as non-surgical interventions such as radiotherapy, cryotherapy, immunotherapy, and topical medications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ciuciulete AR, Stepan AE, Andreiana BC, Simionescu CE (2022) Non-melanoma skin cancer: statistical associations between clinical parameters. Curr Health Sci J 48(1):110–115. https://doi.org/10.12865/CHSJ.48.01.16

    Article  PubMed  PubMed Central  Google Scholar 

  2. Silverman NMD, Shinder R (2017) What’s New in Eyelid Tumors. Asia-Pacific Journal of Ophthalmology 6(2):143–152. https://doi.org/10.22608/APO.201701

    Article  CAS  PubMed  Google Scholar 

  3. Pe’er J (2016) Pathology of eyelid tumors. Indian J Ophthalmol 64(3):177–190. https://doi.org/10.4103/0301-4738.181752

    Article  PubMed  PubMed Central  Google Scholar 

  4. ML Cochran MJ Lopez CN Czyz 2023Anatomy, Head and Neck: Eyelid [Updated 2023 Aug 14] In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing

  5. Lynde C, Gunton L, Weinberg T, Murray C (2014) Periorbital Surface Anatomy for the Dermatologist. J Cutan Med Surg 18(2):141–144. https://doi.org/10.2310/7750.2013.13135

    Article  PubMed  Google Scholar 

  6. B McDaniel T Badri RB Steele Basal Cell Carcinoma [Updated 2022 Sep 19]. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing

  7. Levinkron O, Schwalb L, Shoufani A, Gutovitz J, Krausz J, Briscoe D (2024) Comparison of the clinical characteristics of benign and malignant eyelid lesions: an analysis of 1423 eyelid lesions, compared between ophthalmology department and plastics department. Graefes Arch Clin Exp Ophthalmol 262(2):615–621. https://doi.org/10.1007/s00417-023-06244-5

    Article  PubMed  Google Scholar 

  8. Oliveira D et al (2000) Eyelid and conjunctiva epithelial tumors: a review of risk factors and primary prevention options. ARC Journal of Ophthalmology 5(1):21–29

    Google Scholar 

  9. Bianciotto C, Demirci H, Shields CL, Eagle RC, Shields JA (2009) Metastatic tumors to the eyelid: report of 20 cases and review of the literature. ArchOphthalmol 127(8):999–1005. https://doi.org/10.1001/archophthalmol.2009.120

    Article  Google Scholar 

  10. H Rana TJ Stokkermans B Purt et al. Malignant Eyelid Lesions [Updated 2023 Aug 14]. In: StatPearls [Internet] Treasure Island (FL): StatPearls Publishing

  11. Shi Y, Jia R, Fan X (2017) Ocular basal cell carcinoma: a brief literature review of clinical diagnosis and treatment. Onco Targets Ther 10:2483–2489. https://doi.org/10.2147/OTT.S130371

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Baş Z, Sharpe J, Yaghy A, Zhang Q, Shields CL, Hyman L, IRIS Registry Analytic Center Consortium (2022) Prevalence of and Associated Factors for Eyelid Cancer in the American Academy of Ophthalmology Intelligent Research in Sight Registry. Ophthalmol Sci. 3(1):100227

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ul Kadir SM, Rani Mitra M, Rashid R, Nuruddin M, Hassan Khan MK, Haider G, Nessa MS (2022) Clinicopathological analysis and surgical outcome of eyelid malignancies: a study of 332 cases. J Skin Cancer 2022(18):4075668. https://doi.org/10.1155/2022/4075668

    Article  PubMed  PubMed Central  Google Scholar 

  14. Burgic M, Iljazovic E, Vodencarevic AN, Burgic M, Rifatbegovic A, Mujkanovic A, Halilbasic M, Sinanovic M (2019) Clinical characteristics and outcome of malignant eyelid tumors: a five-year retrospective study. Med Arch 73(3):209–212

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yu SS, Zhao Y, Zhao H, Lin JY, Tang X (2018) A retrospective study of 2228 cases with eyelid tumors. Int J Ophthalmol 11(11):1835–1841. https://doi.org/10.18240/ijo.2018.11.16

    Article  PubMed  PubMed Central  Google Scholar 

  16. Rene C (2013) Oculoplastic aspects of ocular oncology. Eye (Lond) 27(2):199–207. https://doi.org/10.1038/eye.2012.243

    Article  CAS  PubMed  Google Scholar 

  17. Mudhar HS, Nuruddin M, Roy SR (2016) Eyelid Metastatic Thyroid Papillary Carcinoma. Ocul Oncol Pathol. 2(3):156–159

    Article  PubMed  Google Scholar 

  18. Aurora AL, Blodi FC (1970) Lesions of the eyelids: a clinic pathological study. Surv Ophthalmol 15:94–104

    Google Scholar 

  19. Arnold AC, Bullock JD, Foos RY (1985) Metastatic eyelid carcinoma. Ophthalmology 92:114–119

    Article  CAS  PubMed  Google Scholar 

  20. Wang JK, Liao SL, Jou JR et al (2003) Malignant eyelid tumours in Taiwan Eye 17:216–220

    PubMed  Google Scholar 

  21. Weiner JM, Henderson PN, Roche J (1986) Metastatic eyelid carcinoma. Am J Ophthalmol 101:252–254

    Article  CAS  PubMed  Google Scholar 

  22. Ahmad SM, Esmaeli B (2007) Metastatic tumors of the orbit and ocular adnexa. Curr Opin Ophthalmol 18(5):405–413. https://doi.org/10.1097/ICU.0b013e3282c5077c

    Article  PubMed  Google Scholar 

  23. Fonseca NL Jr et al (2009) Metastatic eyelid disease associated with primary breast carcinoma: case report. Arq Bras Oftalmol 72(3):390–393. https://doi.org/10.1590/s0004-27492009000300022

    Article  PubMed  Google Scholar 

  24. Yeung SN et al (2007) Metastatic eyelid disease associated with hepatocellular carcinoma. Can J Ophthalmol 42:752–754

    Article  PubMed  Google Scholar 

  25. Ramez AM, Hamed M, Saad EA (2022) Metastatic renal cel S. l. carcinoma to the eyelid: an unusual presentation. Journal of Clinical Urology. 15(3):213–216

    Article  Google Scholar 

  26. Dhannawat SS, Sherwood C, Bahadur R (2020) Eyelid metastasis from lung adenocarcinoma. Am J Ophthalmol Case Rep 20:100991. https://doi.org/10.1016/j.ajoc.2020.100991

    Article  PubMed  PubMed Central  Google Scholar 

  27. Esmaeli B et al (2000) Leiomyosarcoma of the esophagus metastatic to the eyelid. Ophthalmic Plast Reconstr Surg 18(2):159–161

    Article  Google Scholar 

  28. Universiy of Michigan. https://histology.medicine.umich.edu/resources/eye#electron-micrographs. Jan 19, 2023.

  29. Hwang JR, Khachemoune A (2023) Lower lip basal cell and squamous cell carcinomas: a reappraisal of the similarities and differences in clinical presentation and management. Arch Dermatol Res 315(2):117–125. https://doi.org/10.1007/s00403-022-02345-z

    Article  PubMed  Google Scholar 

  30. Cheng CY, Su HJ, Kuo TT (2020) Dermoscopic features and differential diagnosis of sebaceous carcinoma. J Dermatol 47(7):755–762. https://doi.org/10.1111/1346-8138.15384

    Article  PubMed  Google Scholar 

  31. KA Prickett ML Ramsey 2023 Mohs Micrographic Surgery. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing

  32. Martel A, Lassalle S, Picard-Gauci A, Gastaud L, Montaudie H, Bertolotto C, Nahon-Esteve S, Poissonnet G, Hofman P, Baillif S (2021) New Targeted therapies and immunotherapies for locally advanced periocular malignant tumours: towards a new “eye-sparing” paradigm? Cancers (Basel) 13(11):2822. https://doi.org/10.3390/cancers13112822

    Article  PubMed  Google Scholar 

  33. Pernick N. Anatomy & histology-eyelid. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/eyeeyelidanatomy.html. Accessed October 4th, 2023.

  34. Kato J, Horimoto K, Sato S, Minowa T, Uhara H (2019) Dermoscopy of melanoma and non-melanoma skin cancers. Front Med (Lausanne) 6:180. https://doi.org/10.3389/fmed.2019.00180

    Article  PubMed  Google Scholar 

  35. Mulay K, Menon V, Lahane S, Sharma M, Honavar SG (2019) Endocrine mucin-producing sweat gland carcinoma (EMPSGC) of the eyelid: Clinicopathologic features, immunohistochemical findings and review of literature. Indian J Ophthalmol 67(8):1374–1377. https://doi.org/10.4103/ijo.IJO_1745_18

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

The authors have no financial relationships relevant to this article to disclose.

Author information

Authors and Affiliations

  1. Arizona College of Osteopathic Medicine, Midwestern University Glendale, Arizona, USA

    M. Mukarram

  2. Department of Dermatology, University of New York Downstate and Veterans Affairs Medical Center, 800 Poly Pl, Brooklyn, NY, 11209, USA

    A. Khachemoune

Authors
  1. M. Mukarram
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Khachemoune
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

AK and MM conceived the idea for the manuscript. MM analyzed the literature and drafted the manuscript. All authors edited the manuscript.

Corresponding author

Correspondence to A. Khachemoune.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mukarram, M., Khachemoune, A. Upper and Lower Eyelid Malignancies: Differences in Clinical Presentation, Metastasis, and Treatment. Arch Dermatol Res 316, 429 (2024). https://doi.org/10.1007/s00403-024-03163-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00403-024-03163-1

keywords

Search

Navigation