Eyelid and conjunctival neoplasms

The spectrum of neoplasms that can affect the eyelids and conjunctiva is vast. In this chapter, we review the epidemiology, clinical features, pathology, and management of these lesions. Basal cell carcinoma is the most common eyelid malignancy. Excision is the mainstay of treatment for this tumor that rarely metastasizes. Squamous cell carcinoma is the second most common eyelid malignancy. It has a higher risk of nodal and systemic metastasis. A high index of suspicion is necessary for sebaceous carcinoma as it can appear similar to other conditions. Cutaneous melanoma of the eyelid has a propensity for nodal and systemic metastasis. Although local excision is central to the management, frozen sections are not adequate for control of the margins. Numerous other tumors can affect the eyelids, including sweat gland tumors, Merkel cell carcinoma, vascular tumors, lymphoma, and metastatic tumors. Conjunctival melanoma is rare but potentially lethal. Excision is usually accompanied by adjuvant treatments, such as cryotherapy and topical chemotherapy. Squamous conjunctival lesions include both benign and malignant lesions. Human papillomavirus and human immunodeficiency virus have been associated with these lesions.