Basal cell carcinoma (rodent ulcer) is the commonest cancer of the eyelid. The classic presentation of a BCC is a hard nodule with a pearly edge, often with dilated blood vessels on its surface (telangiectasia) and central ulcer formation as the BCC enlarges.
Eyelid BCCs arise from within the superficial layers of skin, most commonly involving the lower eyelid. The risk of BCC development in any particular person is related in part to the fairness of that person’s skin and the amount of sun exposure that person receives. Although it does not spread to distant sites (metastasis), it can continue to enlarge and invade surrounding structures. On the whole, surgery for larger tumours is likely to be more extensive.
Although the best chance of cure of eyelid cancers is via complete surgical removal; some patients with BCC may be treated with other methods e.g. radiotherapy, cryotherapy, topical chemotherapy, immunotherapy.
Less commonly, other types of cancers may develop around the eye e.g. malignant melanoma, squamous cell carcinoma, sebaceous gland carcinoma. They are by far much less common than BCCs, but their management on the whole requires more radical treatment than BCCs, at times involving joint care with other types of doctors e.g. oncologists, maxillofacial surgeons, general plastic surgeons, due to their ability to spread to distant sites.
BCCs differ from most cancers in that they rarely spread to distant sites.
All skin cancers around the eyelids are designated as high risk skin cancers by the British Association of Dermatologists and as such should be treated seriously.
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(Warning: some of the pictures are quite graphic and may cause distress)