MALIGNANT TUMORS

most common human malignancy. More common on lower lid. Locally invasive but non-metastatic.

Risk factor

• fair skin.

• chronic sun exposure

Clinical features 

• may mimic a nodule

• rodent ulceration: rolled edges with surface vessels

• sclerosing type spread underneath the skin

Less common than BCC. Metastatic. May spread to preauricular lymph nodes which must be checked in any lid tumor

risk factors

• chronic sun exposure

• fair skin 

• immunocompromised patients 

Clinical features

may resemble nodule:

ulceration:  everted borders but surface vessels are absent.

• Rare. 

• more common on upper lid because of increased number of meibomian glands in upper lid. 

• 10% mortality

Clinical features

• yellowish material in tumor

• nodule in upper lid which may resemble chalazion

• spreading tumor under the skin  may resemble blepharitis

Surgery

Biopsy 

which may be incisional or excisional 

surgical excision

conventional paraffin embedded specimen

frozen section technique: margins are checked at the time of surgery. if tumor free, reconstruction is done same day

Mohs micrographic surgery: lesion is mapped histologically and exicion is done at the place of lesion

After excision of tumor with some normal healthy surrounding tissue

For small defect: up to one third of lid, direct closure is done. 

INTERMEDIATE: Upto half of lid defects, semicircular flaps are done for example Tenzil semicircular flaps

LARGE: More than half defectsfree skin grafts and flaps are done.