Basal cell carcinomas are a type of skin cancer that originates from the top layer of the skin called the epidermis and is also the most common cancer of the eyelid. They make up 90% of malignant tumors of the eyelid. These tumors most commonly occur on the lower eyelid and the junctions where the two eyelids meet.
What are the risk factors?
- Excessive sun exposure
- Radiation exposure
- Individuals with immune deficiency, especially organ transplant recipients
- Individuals with scars (due to previous trauma)
- Certain hereditary conditions like Xeroderma Pigmentosum can also increase the risk.
I have a lump on my eyelid, could it be Basal cell carcinoma?
Certainly, not every lump on the eyelid is a tumor. However, there are some signs listed below that may lead us to suspect a tumor. These tumors can sometimes be present as a simple eyelid mass without any complaints, but they can also lead to the following problems:
- Sores on the lump, sometimes with bleeding
- Scaling of the skin
- Prominent blood vessels on or around the lump
- Loss of eyelashes at the edge of the eyelid (madarosis)
- Wrinkling and indentation of the eyelid skin
- Deformities of the eyelid
How is Basal cell carcinoma diagnosed?
A thorough examination of the eyelid and eye is initially required. In most cases, your eye doctor can make the diagnosis through examination, but to confirm it, a biopsy of the lump is necessary, followed by examining the tissue sample in a pathology lab.
Are Basal cell carcinomas dangerous cancers?
While these cancers are malignant, they generally have a good prognosis and do not metastasize (spread to distant areas) but can grow locally and extend into the eye and its surroundings. Unfortunately, when they invade the eye, it can be quite challenging to save the eye.
Is there a treatment, and how is it treated?
Although these cancers can be treated with some creams, surgery is the most definitive treatment. After a successful surgery, they have a 98% chance of not recurring within 5 years. Small tumors can be completely removed in one procedure under local anesthesia, but larger tumors that have spread over a significant portion of the eyelid require a more detailed approach. For larger tumors, an incisional biopsy is first performed to obtain a small sample that is sent to pathology. Once the pathology results are confirmed, surgery should be planned. The surgery should be performed with frozen section guidance, meaning a pathology specialist should be present during surgery. After the tumor is surgically removed, it should be immediately examined by the pathology specialist, and if it is completely removed, the second stage can proceed. Otherwise, suspicious areas should be re-excised and examined. In the second stage, if necessary, the eyelid may need to be reconstructed, especially in cases of large tumors that require the removal of a significant portion of the eyelid.
How can one protect themselves from Basal cell carcinomas?
It’s important to avoid the risk factors mentioned above, especially preventing sun exposure, which is a preventable factor. Wearing a hat and using sunglasses are essential, especially during the summer months.