Eyelid and orbital tumors

Eyelid and orbital tumors

WHAT YOU NEED TO KNOW ABOUT EYELID AND ORBITAL TUMORS IN A NUTSHELL…

  • Eyelid tumors are those tumors that appear in the eyelids in the form of small injuries, pimples or lumps that usually don’t cause symptoms, although in some cases they may itch, sting or even bleed and produce scabs.
  • Orbital tumors are those that are located in the orbital cavity that surrounds the eye, reason why some of them are difficult to access. The patient may notice that his eyes are bulging or misaligned, and he may experience double vision.
  • Both tumor types may be benign or malignant (cancerous), in which case it is necessary to try to remove them.
  • Removal of eyelid tumors has usually a high success rate, provided that the tumor is fully removed, together with healthy tissue from around.
  • The prognosis of orbital tumors varies depending on the origin of the disease. These tumors may not be always removed, due to the difficult access.
  • In case of eyelid tumors, sun damage is usually the main risk factor. People who have been exposed to sun for years, whether for work or for voluntary exposure, as well as people at advanced ages and people with clear skin are at a higher risk of suffering such tumors.

Eyelid and orbital tumors

Tumors are abnormal tissue masses that may be benign or malignant (cancerous). Palpebral tumors are those tumors that appear in the eyelids, while orbital tumors appear within the orbital cavity or eye socket that surrounds the eye. Sun exposure is the main risk factor for eyelid tumors.

Palpebral (or eyelid) tumors

Orbital tumors

Injury or lump in the eyelid that usually doesn’t cause symptoms. Sometimes they itch, sting or bleed and produce a scab.

Internal, non-visible tumor that may cause the patient a feeling of having bulging or misaligned eyes, thus causing double vision.

Regardless of its location, they may be benign or malignant, and they must be examined preferably by oculoplastics specialists in order to try to remove them, whenever possible, with the aim of completely eliminate them.


What are eyelid and orbital tumors?

Tumors are abnormal tissue masses. It is usual for patients when they hear the word “tumor” to associate it with something bad. But it is not always like that. Sometimes, tumors are proliferations or growths of benign cells, so they are not cancerous; in other cases, tumors are proliferations of malignant cells, thus being cancerous.

  • Eyelid tumors are those located on eyelid skin.
  • Orbital tumors are those located in the orbital cavity, which is the cavity surrounding the eye. This cavity has muscles, blood vessels… And any of these structures may suffer from a tumor.

What kind of tumors are there? Can they be malignant?

There are lots of tumor types, both palpebral and orbital. There are benign and malignant tumors, and even some that may start being benign and they later become malignant. Therefore, when faced to a tumor suspicion, a monitoring must be made in order to know whether the tumor may or not become malignant.


What troubles and effects do they cause?

What shocks the most and should call the attention of patients and make them come to the consultation is that many of these tumors, especially eyelid tumors, appear as small injuries or lumps to which they do not attach importance, because they grow little by little without causing disturbances, and only in very few cases they cause itching or stinging. Sometimes they bleed a little bit and produce a scab, but they are the typical lumps that do not cause discomfort and people do not pay any attention to them, so when they come to the consultation, the tumor is wider and more difficult to remove.

It is very important for a patient when he notices any lesion in his eyelid that does not cause pain, but bleeds or itches, and changes in size or color, to come to the ophthalmologist, preferably to an oculoplastics specialist, in order to have the lesion examined and obtain an early diagnosis and treatment, which are essential.

Orbital tumors are somewhat different, as they are inside the eye socket and the patient will experience symptoms. He may notice that his eyes are bulging or misaligned, or that he starts seeing double. Usually, this draws the attention of patients and they come earlier to a consultation. Therefore, in these cases, the diagnosis is usually not delayed, although in some cases these tumors’ growth may take place so slowly that when they cause symptoms, its size is already too big.


Who is at a higher risk of suffering from such tumors?

The skin of people who have been exposed throughout life to sun, whether for leisure or work, is more damaged, so they are at a higher risk of suffering skin cancer. These people should have their face skin examined, as it is the area which is usually more exposed to sun, including skin around the eyes, and when they find any lesion in the area, they should come to the specialist and have it examined.

Age where eyelid and orbital tumors more often appear depends on the type of tumor. Some are more frequent during childhood, while others appear most frequently at advanced ages. Generally, it is above the age of 50 when they most usually appear.

People with 1 and 2 skin phototypes should take higher care, as they have very light skin and a higher risk of suffering skin cancer.


Why do they appear? Can they be prevented?

As they are many kinds of tumors, the production mechanism for each one of them is different. But in eyelid tumors, the risk factor is sun damage. Skin highly damaged by the sun causes higher chances of suffering a skin cancer.  It is very important to use a proper sun protection. We should:

  • wear sunglasses
  • use sunscreen (there are face sunscreens that may be applied on eyelid skin)
  • and avoid sun exposure during the intense sun hours from 12h to 15h.

Patients who already suffer skin cancer in other body areas, especially in the face skin should go immediately to the specialist when they discover any lesion in their eyelids that is not painful but bleeds or itches, in order to obtain an early diagnosis.


How are they diagnosed?

When a patient arrives at the consultation and we see a lesion that is suspected of being malignant and we believe it may be cancerous, we’ll need to know the type of tumor we are faced to, and confirm if it is indeed cancerous.

The most reliable way we have to know what kind of lesion we are facing is by means of a biopsy. Biopsies allow us to collect a piece of tissue, analyze it and classify it. This is really important, as depending on the type of tumor, the treatment could differ.

If eyelid tumors are small and we can remove them completely with an only surgical intervention, we’ll do it and wait the biopsy results. Both if it is cancerous or not, we’ll be reassured because we have completely removed it.

In case of large tumors, biopsies serve to confirm whether it is cancerous and, if so, proceed to the complete removal of the lesion, which may require sometimes complex reconstruction by means of grafts or flaps.

In case of orbital tumors, it isn’t always possible to perform a biopsy. Many of them are diagnosed by clinical features the patient has and the results of image tests, such as CT or MRI procedures…


How can they be treated? Is there any chance of recurrence?

The treatment will depend on the tumor type. Small benign eyelid tumors may be easily removed with a small surgery. But other larger tumors may require more complex surgeries. Malignant tumors must be completely removed; sometimes this is quite easy, but other times it requires complex surgeries performed in two or three times.

In terms of orbital tumors, the treatment will be different, and will depend on the tumor type. Its sensitive location means they cannot always be removed.  Those providing easy access to the surgeon may be removed, but with those located at difficult access areas, monitoring will be necessary, and they will need to be assessed at each time in order to determine how to proceed. They do not always require a surgical treatment. The most frequent orbital primary tumor is lymphoma. It is diagnosed through a biopsy, but its treatment isn’t surgical, but radiotherapy or chemotherapy is instead used, depending on histological type.


Which is the success rate for this tumors’ removal?

In case of malignant eyelid tumors, if we achieve to remove the whole tumor and the healthy tissue that surrounds it, the success rate will be high, and chances it reappears are low. However, we monitor them in consultation after the tumor removal for an early detection of any possible recurrence or reappearance, in which case a new intervention could be performed.

In case of orbital tumors, the success rate will vary depending on the tumor type.

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