Benign eyelid tumors

Benign eyelid tumors constitute the main group of eyelid tumors.

The source of growth of benign eyelid tumors can be skin elements (papilloma, senile wart, follicular keratosis, keratoacanthoma, senile keratosis, cutaneous horn, Bowen's epithelioma, pigment xeroderma), hair follicles (Malherbe's epithelioma, trichoepithelioma). Less common are tumors originating from other tissues.

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Papilloma of the eyelids

Papilloma of the eyelids accounts for 13-31% of all benign tumors of the skin of the eyelids. Papilloma usually occurs after 60 years of age, its favorite localization is the lower eyelid. The tumor grows slowly, it is characterized by papillary growths of a spherical or cylindrical shape. The color of the papilloma is grayish-yellow with a dirty coating due to the horny plates covering the surface of the papillae. The tumor grows from skin elements, has a developed stroma. Cellular elements are well differentiated, the covering epithelium is thickened. Treatment of papilloma of the eyelids is surgical. Malignancy of papilloma of the eyelids is observed in 1% of cases.

Senile wart of the eyelids

Senile wart of the eyelids develops after 50 years. It is localized in the temple area, eyelids, along the ciliary edge or in the intermarginal space, more often the lower eyelid. It looks like a flat or slightly protruding formation with clear and even boundaries. The color is gray, yellow or brown, the surface is dry and rough, the horny plates are differentiated. Growth is slow. Laser evaporation or cryodestruction are effective in treatment. There are known cases of malignancy, but without metastasis.

Senile keratosis of the eyelids

Senile keratosis of the eyelids appears after 60-65 years. It grows in areas exposed to insolation, especially often in the area of the skin of the eyelids, in the form of multiple flat white areas covered with scales. Microscopic examination reveals thinning or atrophy of the epidermis. The most effective treatment methods are cryodestruction and laser evaporation. In the absence of treatment, malignancy occurs in about 20% of cases.

Cutaneous horn of the eyelids

The cutaneous horn of the eyelids is a finger-shaped skin outgrowth with keratinization elements, its surface has a grayish-dirty shade. It is diagnosed in elderly people. Electro- or laser excision is used for treatment.

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Bowen's epithelioma of the eyelids

Bowen's epithelioma of the eyelids is represented by a flat, rounded spot of dark red color. The tumor thickness is insignificant, the edges are smooth, clear. It is covered with delicate scales, which when removed reveal a wet surface. Infiltrative growth appears when it turns into cancer. Effective treatment methods are cryodestruction, laser evaporation and short-range radiotherapy.

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Xeroderma pigmentosum of the eyelids

Xeroderma pigmentosa of the eyelids is a rare disease with an autosomal recessive type of inheritance. It manifests itself in young children (up to 2 years) as increased sensitivity to ultraviolet radiation. In places exposed to even short-term insolation, foci of skin erythema appear, subsequently replaced by areas of pigmentation. The skin gradually becomes dry, thinned, rough, and telangiectasias develop on its atrophied areas. After 20 years, multiple tumor foci, most often basal cell carcinoma, appear on the altered areas of the skin, along the edge of the eyelids. Treatment is to exclude ultraviolet radiation.

Capillary hemangioma of the eyelids

Capillary hemangioma of the eyelids is congenital in 1/3 of cases and is more often observed in girls. In the first 6 months of life, the tumor grows rapidly, then a period of stabilization occurs, and by the age of 7, most patients can experience complete regression of the hemangioma. The tumor has the form of bright red or bluish nodes. It is most often localized on the upper eyelid, grows into it, which leads to the appearance of partial and sometimes complete ptosis. As a result of the closure of the palpebral fissure, amblyopia develops, and due to the pressure of the thickened eyelid on the eye, corneal astigmatism occurs. There is a tendency for the tumor to spread beyond the skin of the eyelids. Microscopically, the hemangioma is represented by capillary slits and trunks filled with blood. Treatment of flat superficial capillary hemangioma is carried out using cryodestruction. With the nodular form, immersion diathermocoagulation with a needle electrode is effective, with widespread forms, radiation therapy is used.

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Nevi of the eyelids

Nevi of the eyelids - pigmented tumors - are detected in newborns with a frequency of 1 case per 40 children, in the second - third decades of life their number increases sharply, and by the age of 50 it decreases significantly. The source of nevus growth can be epidermal or dendritic melanocytes, nevus cells (nevocytes), dermal or spindle-shaped melanocytes. The first two types of cells are located in the epidermis, and the latter - in the subepithelial layer. The following types of nevi are distinguished.

Borderline (functional) nevus of the eyelids is typical for childhood, it is represented by a small flat dark spot, located mainly along the intermarginal edge of the eyelid. Treatment consists of complete electroexcision of the tumor

Juvenile (spindle cell) nevus of the eyelids appears in children and young people as a pinkish-orange well-defined nodule, on the surface of which there is no hair. The tumor grows quite slowly. Treatment is surgical.

Giant (systemic melanocytic) nevus of the eyelids is detected in 1% of newborns. As a rule, the tumor is large, intensely pigmented, can be located on symmetrical areas of the eyelids, since it develops as a result of migration of melanocytes at the stage of embryonic eyelids before their division, captures the entire thickness of the eyelids, spreading to the intermarginal space, sometimes to the conjunctiva of the eyelids. The borders of the nevus are uneven, the color is light brown or intensely black. The tumor can have hair and papillary growths on the surface. Growth throughout the entire thickness of the eyelid leads to the appearance of ptosis. Papillary growths along the edge of the eyelids and abnormal growth of eyelashes cause lacrimation, persistent conjunctivitis. Treatment is effective with step-by-step laser evaporation, starting from infancy. The risk of malignancy in large nevi reaches 5%; foci of malignancy form in the deep layers of the dermis, which makes its early diagnosis practically impossible.

Nevus of Ota, or oculodermal melanosis of the eyelids, arises from dermal melanocytes. The tumor is congenital, almost always unilateral, and manifests itself as flat spots of reddish or purple color, usually located along the branches of the trigeminal nerve. Nevus of Ota may be accompanied by melanosis of the conjunctiva, sclera, and choroid. Cases of malignancy have been described with a combination of nevus of Ota and uveal melanosis.

Benign nevi of the eyelids can progress with different frequency and speed. In this regard, it is extremely important to identify the signs of nevus progression: the nature of pigmentation changes, a halo of delicate pigment forms around the nevus, the surface of the nevus becomes uneven (papillomatous), stagnant-full-blooded vessels appear along the periphery of the nevus, its size increases.