A retrospective study of 2228 cases with eyelid tumors

AIM： To describe the histopathologic and clinical features of eyelid tumor cases from Tianjin Eye Hospital during 2002 to 2015. METHODS： In this retrospective study, a total of 2228 cases of eyelid tumors with pathologic diagnoses were enrolled. The eyelid tumors were classified into three groups according to tumor origin： epidermal, adnexal and miscellaneous, including melanocytic, neural and vascular lesions. Inflammatory tumor-like lesions were excluded. The clinical characteristics of the eyelid tumors were analyzed, including age, gender and lesion location. RESULTS： Most eyelid tumors were epidermal in origin（1080, 48.5%）, followed by miscellaneous（885, 39.7%） and adnexal tumors（263, 11.8%）. Among all the tumors, 292（13.1%） were malignant lesions, 1910（85.7%） benign and 26（1.1%） premalignant lesions. Most malignant tumors originated from epidermal cells（60.0%）, followed by adnexal cells（34.6%）. The most common malignant tumors were basal cell carcinomas（56.5%） followed by sebaceous carcinoma（34.6%）, squamous cell carcinomas（3.8%） and lymphoma/plasmocytoma（1.7%）. The benign and premalignant eyelid lesions mostly originated from epidermal cells（46.4%） followed by miscellaneous cell sources（45.2%）, including melanocytic nevus（33.8%）, seborrheic keratosis（13.7%）, squamous cell papilloma（13.0%） and epidermal cysts（11.5%）. CONCLUSION： Eyelid tumors are mostly epithelial in origin. Benign tumors are significantly more common than malignant tumors with an obvious female predominance, and the most frequent malignant tumor are basal cell carcinoma, sebaceous carcinoma and squamous cell carcinomas. The tumor clinical features varied among the different subtypes.

Clinicopathologic features and prognostic factors of malignant eyelid tumors

AIM:To investigate the clinical characteristics and prognosis of patients with malignant eyelid tumors.·METHODS:This was a retrospective,non-randomized,clinical reviews.Between January,2002 and December,2011,75 cases with histologically confirmed malignant eyelid tumors were evaluated.Patients’ charts were reviewed for clinical information,treatment procedure,and disease course.Survival analysis in terms of recurrence-free survival was performed using age,sex,location of tumor and histopathological type.The followup ranged from 1 to 78 months(mean=21 months).·RESULTS:The 75 eyelid tumors included 35 basal cell carcinoma(BCC,46.7%),22 sebaceous gland carcinoma(SGC,29.3%),7 squamous cell carcinoma(SCC,9.3%),10 malignant melanoma(MM,13.3%),and 1 Merkel cell carcinoma(MCC,1.3%).Recurrence developed in 17cases(22.7%).The recurrence rate of BCC(4/35,11.4%)was significant lower than MM(6/10,60.0%,P 【0.001).The mean interval of recurrence was 21 months(range 3-62) for all eyelid tumors.Tumor located at canthus had higher recurrence rate(50%) compared with those located at eyelid(19%,P 【0.05).Histological type was independent variable for recurrence by Cox regression analysis.·CONCLUSION:It is important to achieve a negative tumor margin in canthus located malignant eyelid tumor.Clinicians should have a high level of suspicion for recurrence according to histological type when treating patients with eyelid tumor.

Demographic features and histopathological diagnosis in primary eyelid tumors: results over 19 years from a tertiary center in Ankara, Turkey

AIM:To evaluate the demographic features,location,and histopathologic results in primary eyelid tumors.METHODS:We retrospectively reviewed the records of patients with primary eyelid tumor diagnosed and treated between November 1997 and June 2016 on our service.RESULTS:Nine hundred and eleven lesions from 874 patients were included in this study.Four hundred and fortysix(51.0%)of the patients were females and 428(49.0%)were males.The mean age was 51.0y(range:3 mo-94 y).The lesions were located in the upper eyelid(418 cases,45.9%),lower eyelid(378 cases,41.5%),medial canthus(89 cases,9.8%),and lateral canthus(26 cases,2.8%).Four hundred and seventy(51.6%)lesions were located on the right side and 441(48.4%)on the left.Of the eyelid lesions,666(73.1%)were benign,230(25.2%)malignant,and 15(1.6%)premalignant.When the eyelid tumors were classified according to their tissue or cell of origin,527(57.8%)of the lesions were found to be epidermal,171(18.8%)adnexal,131(14.4%)inflammatory and infectious,and 65(7.1%)stromal.The most common benign lesions were squamous cell papilloma(139 lesions,15.2%),intradermal nevus(97 lesions,10.6%),epidermoid inclusion cysts(78 lesions,8.6%),seborrheic keratosis(60 lesions,6.6%),and inflammatory masses(59 lesions,6.5%).Basal cell carcinoma was the most common malignant tumor(191 lesions,21.0%)followed by squamous cell carcinoma(16 lesions,1.8%),sebaceous carcinoma(14 lesions,1.5%),and malignant melanoma(5 lesions,0.5%).CONCLUSION:In this study,73.1%of eyelid lesions are benign and the remaining 26.9%are premalignant and malignant.Basal cell carcinoma is the most common tumor among all histopathological diagnosis followed by squamous papilloma.

Expression of P16 protein and Bcl-2 protein in malignant eyelid tumors

Objective To investigate the relationship between P16 gene (the tumor suppressor gene) and the bcl-2 gene (the apoptosis inhibitor gene) and the incidence and development of malignant eyelid tumors. Methods The streptavidin-biotin-peroxidase complex immunohistochemistry method was used to study the expression of P16 gene and the bcl-2 gene in 96 cases of malignant eyelid tumors. [WTF5絉esults [WTFZ]Among the 96 cases, there were 40 basal cell carcinomas (BCCs), 33 squamous carcinomas and 23 sebaceous carcinoma, with P16 protein positive (nuclear staining) rates 70%, 54.6% and 56.5%, respectively. The P16 positive rate was negatively correlated with the degree of tumor histological differentiation, and the rate difference between the high differentiated carcinomas was significant (P【0.05). Positive Bcl-2 protein expression was detected in the cytoplasm. All 40 BCC cases were Bcl-2 positive, and nearly all of the tumor cells showed positive cytoplasmic expression, while in the 33 squamous cell carcinoma cases only one showed positive focal reaction, and the staining in the other 32 cases was relatively faint. None of the 23 sebaceous carcinomas expressed Bcl-2. Conclusions The expression of the P16 protein was related to the occurrence and degree of differentiation of malignant eyelid tumors. The overexpression of the Bcl-2 protein suggests that suppression of apoptosis might play a role in the tumorigenesis of BCC.

Treatment of Nevoid Basal Cell Carcinoma Syndrome by Surgery Combined With ALA-PDT: A Case Report

Introduction:Nevoid basal cell carcinoma syndrome is an autosomal dominant disorder characterized by developmental malformations and carcinogenic activity.Multi-systemic anomalies may occur in this syndrome,such as odentogenic keratocysts of the mandible and postnatal tumors,especially multiple basal cell carcinoma.Case presentation:A 60 year old man presented with systemic plaques and nodules for more than 30 years.Cutaneous examination revealed that invasive erythema and black papules scattered on the face,trunk and limbs.He underwent extended surgical excision of lesions at multiple sites.No new lesions were found in the treated areas during a 3-year follow-up.Topical 5-aminolevulinic acid-mediated photodynamic therapy(ALA-PDT)was given as a palliative treatment for ulcerated tumors on the right lower eyelid and bleeding of the right temporal lesion.After application of ALA-PDT,the ulcers almost healed and the recurring hemorrhage ceased.Discussion:The management of multiple tumors in patients with nevoid basal cell carcinoma syndrome is extremely difficult,especially in the face.Surgical excision is the standard method,but the procedure can be applied in limited sites and may result in significant disfigurement and the difficulty of wound recovery.PDT can play a significant role in combination therapy for tumors that are extremely difficult to remove completely by surgical excision.Conclusion:We present a rare case manifested as multiple basal cell carcinoma and palmar pits who treated by surgery combined with topical 5-aminolevulinic acid-mediated photodynamic therapy.The combined therapy plays a complementary role in the treatment of nevoid basal cell carcinoma syndrome.