Eyelid and Orbital Tumors

The thought of cancers involving the eyelids, the eyeball or the tissues within the bony orbit are frightening to most people. However, many tumors are benign in nature and even most malignant tumors rarely represent a “death sentence.” There is life after periorbital tumors and most patients develop a greater appreciation of their daily lives after the experience.

Tumors that commonly involve the eyelid and its surrounding structures usually require a surgical procedure to diagnose and/or treat. The advances in medical science over the past several decades have allowed us to successfully diagnose, treat and even cure many tumors.

When tumors are small, they are a small problem and when they grow larger they become a more difficult problem. On this basis, you should not be afraid to seek treatment, as early diagnosis is helpful. The earliest signs of most tumors are a progressive lump, bleeding, texture change, irregular pigmentation or surrounding tissue destruction. In some cases, tumors will exert a secondary effect on the surrounding normal tissues, such as when an eyelid contour defect occurs or if the eyeball is pushed forward. In these cases, when the underlying tumor is removed the secondary problem should resolve.

The goal with tumor surgery depends upon the nature of the underlying process. Frequently, the history, growth pattern and appearance of the tumor will lead to a diagnosis. Occasionally, imaging studies are necessary to determine the full extent of the tumor and suggest the best surgical approach. In all cases, a surgical biopsy is necessary to confirm the correct diagnosis. The biopsy may be incisional to determine the nature of the tumor or excisional to completely remove the tumor.

The removal of a tumor typically leaves a tissue defect that will require some form of reconstruction. Fortunately, there are a number of techniques that have been developed and refined to restore normal function and appearance. These techniques include direct closure, skin grafts, advancement flaps, implants, and eyelid sharing procedures.