Benign tumors of the eyelids

Benign tumors of the eyelids constitute the main group of tumors of the eyelids.

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

[1], [2], [3]

Papilloma of the eyelids

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

Senile eyelid wart

The senile wart of the eyelids develops after 50 years. It is localized in the field of the temple, the eyelids, along the ciliary margin or in the intermarginal space, often the lower eyelid. It has the appearance of a flat or slightly protruding formation with clear and even boundaries. Color gray, yellow or brown, the surface is dry and rough, the horny plates are differentiated. The growth is slow. Laser evaporation or cryodestruction is effective in treatment. There are 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 plural flat areas of white, covered with scales. At a microscopic examination, thinning or atrophy of the epidermis is detected. The most effective methods of treatment are cryodestruction and laser evaporation. In the absence of treatment, malignancy occurs in about 20% of cases.

Cutaneous eyelid

The dermal horn of the eyelids is a finger-like dermal outgrowth with elements of keratinization, its surface has a greyish-dirty shade. Diagnose in the elderly. Electro- or laserexcision is used in the treatment.

[4],

Bowen's epithelioma eyelids

Epithelioma Bowen's eyelid is flat, rounded in a spot of dark red color. Thickness of the tumor is insignificant, the edges are even, clear. It is covered with delicate scales, when removing them, the wetting surface is exposed. Infiltrative growth occurs when you go to cancer. Effective methods of treatment - cryodestruction, laser evaporation and short-distance X-ray therapy.

[5], [6], [7], [8], [9]

Pigment xeroderma

Pigment xeroderma of the eyelid is a rarely observed disease with an autosomal recessive type of inheritance. It appears in young children (up to 2 years) in the form of hypersensitivity to ultraviolet radiation. In places exposed to even short-term insolation, there are foci of skin erythema, subsequently replaced by areas of pigmentation. The skin gradually becomes dry, thinned, rough, on its atrophied sites develop telangiectasias. After 20 years on the changed skin areas, on the edge of the eyelids there are multiple tumor sites, more often basal cell carcinoma. Treatment - to exclude ultraviolet irradiation.

Capillary hemangioma

Capillary hemangioma in one-third of cases is congenital, it 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, the complete regression of the hemangioma is possible in most patients. The tumor has the appearance of nodes of bright red color or cyanotic. It is more often localized on the upper eyelid, sprouts it, which leads to the appearance of partial, and sometimes complete, ptosis. As a result of the closure of the eye fissure, amblyopia develops, and due to the pressure of the thickened eyelid, corneal astigmatism appears on the eye. There is a tendency to spread the tumor beyond the skin of the eyelids. Microscopically, the hemangioma is represented by capillary slits and blood filled stems. Treatment of a flat surface capillary hemangioma is performed by cryodestruction. With the nodal form, an immersion diathermocoagulation with a needle electrode is effective, and in case of common forms, radiation therapy is used.

[10], [11], [12], [13], [14], [15]

Nevus eyelids

Nevuses of the eyelids - pigmented tumors - are detected in newborns with a frequency of 1 case for 40 children, in the second - in the third decades of life their number increases dramatically, and by 50 years significantly decreases. The source of nevus growth can be epidermal or dendritic melanocytes, nevus cells (nevocytes), dermal or fusiform 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.

The borderline (functional) nevus is characteristic of childhood, represented by a small flat dark spot, located mainly along the intermarginal margin of the eyelid. Treatment consists in complete electroexcision of the tumor

A juvenile (spindle cell) nevus appears in children and young people in the form of a pinkish orange well-delimited nodule, on the surface of which there is no hair cover. The tumor increases slowly enough. Treatment is surgical.

Giant (systemic melanocytic) nevus is detected in 1% of newborns. As a rule, the tumor is large, intensely pigmented, it can be located on symmetrical eyelids, as it develops as a result of migration of melanocytes at the stage of embryonic eyelids before their separation, captures the entire thickness of the eyelids, extending to the intermarginal space, sometimes to the conjunctiva of the eyelids. The boundaries of the nevus are uneven, the color is light brown or intensely black. The tumor can have a hair covering and papillary growths on the surface. Growth throughout the thickness of the century leads to the appearance of ptosis. Papillary growths along the edge of the eyelids and incorrect growth of the eyelashes cause lacrimation, persistent conjunctivitis. Treatment is effective in phased laser evaporation, beginning with infant age. The risk of malignancy with large nevi reaches 5%, malignancy focuses are formed in the deep layers of the dermis, in connection with which its early diagnosis is almost impossible.

Nevus Ota, or oculodermal melanosis of the eyelids, arises from dermal melanocytes. The tumor is congenital, almost always one-sided, manifested by flat spots of reddish or purple color, usually located along the branches of the trigeminal nerve. Nevus Ota can be accompanied by melanosis of the conjunctiva, sclera and choroid. Cases of malignancy are described in the combination of nevus Ota with uveal melanosis.

Benign nevuses 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 pigmentation character changes, a halo of tender pigment forms around the nevus, the surface of the nevus becomes uneven (papillomatous), stagnant-full blood vessels appear on the periphery of the nevus, its sizes increase.