Anuradha Alagusundaram, Malarvizhi Raman
BACKGROUND
Eyelid lesions are categorised into inflammatory, infectious and neoplastic. Among tumours encountered by ophthalmologist, most common neoplasms are those of eyelids. This study is to evaluate the incidence, mode of onset, various clinical presentations of lid tumours. The various treatment modalities and the final outcome of treatment were also assessed.
MATERIALS AND METHODS This is a retrospective study of 40 patients with various lid tumours who presented to the Oculoplasty Department of Regional Institute of Ophthalmology and Govt. Ophthalmic Hospital Chennai, between Jan 2006 to Dec 2008. 40 patients presenting with lid tumours were evaluated with detailed history taking, complete general examination, ocular examination, slitlamp biomicroscopy, refraction, ophthalmoscopy, intraocular pressure, laboratory investigations, radiological investigations and histopathological evaluation.
RESULTS
Among the 40 patients with lid tumours, 23 patients had benign tumours and 17 patients had malignant lid lesions. Haemangiomas rank first among benign tumours with 6 cases (26%) and sebaceous gland carcinoma is more common in the malignant group. Correlation with HPE diagnosis was obtained in 82% of malignant tumours. In the malignant group, tumor excision with primary closure was done in 2 cases (11.7%) of cases, cantholysis was combined with excision in 3 cases (16.5%). Various types of rotation flaps / lid sharing techniques were used in 7 cases (41.2%). 26.6% of cases were referred for radiotherapy. Recurrence was reported in sebaceous carcinoma. The mortality rate is 11.7%.
CONCLUSION Haemangiomas are the most commonly occurring benign tumours and sebaceous gland carcinomas are the most common among the malignant tumours. Upper lid was the most common site. Sebaceous gland carcinoma can be considered as the first diagnosis in cases presenting with nodulo-ulcerative form and BCC or squamous cell carcinoma in cases presenting as ulcers. Malignant tumours when detected early, respond well to primary excision of tumor with appropriate lid repair procedures. Adequate surgical clearance prevents recurrence. The key to successful reconstruction is surgical planning.
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