Malignant eyelid tumours

The word “tumor” can be a frightening word for people to hear – many patients view “tumour” as being synonymous with “malignant cancer”. It’s important not to confuse the two terms.

The first distinction to be made is the difference between an inflammatory swelling in the eyelid area and “more tissue”. Eyelid tissue is delicate and a slight inflammation can lead to a massive swelling, and there can be many causes of this inflammation, including an inflamed lacrimal gland or an infection caused by a small injury.

If there is a real “extra tissue” (such as from a tumor), then it is often benign changes such as an encapsulated barley grain, a wart, or a so-called “molluscum contagiosum”, caused by a harmless, but contagious virus.

However, various malignant tumors (carcinomas) do occur on the eyelids. The most common malignant eyelid tumor is basal cell carcinoma (90%), followed by squamous cell carcinoma (~5%) and sebaceous carcinomas (~5%). In all cases, suspected malignant tumors should be treated quickly. If necessary, we will consult specialists of other disciplines such as internists, dermatologists or oncologists (cancer specialists).

Malignant cancers on the eyelid

Basal cell carcinoma (BCC): 90% of all malignant eyelid tumours. BCCs are the result of intensive, long-term sun exposure of the skin, preferably in fair-skinned people. BCCs grow locally and only rarely form new tumours (metastases) in other parts of the body.

Squamous cell carcinomas (SCC): make up about 5% of malignant lid tumours. Here, too, excessive sunlight plays a role. The lower eyelid, like in BCC, is more frequently affected because it receives more sunlight. Squamous cell carcinoma metastasizes in about 20% of cases, initially to the lymph nodes of the ear and jaw.

Sebaceous Carcinomas: Make up about 5% of malignant eyelid tumours. Arises on degeneration of a sebaceous gland. This tumour is aggressive and metastasizes early.

The operation

Biopsy

For small tumors, we first take a biopsy in a short outpatient procedure. The material is sent to a laboratory and examined under the microscope to confirm the diagnosis. In a second operation, the tumor is removed.
For large tumors, the tumor is excised, plus an additional region of what appears to be non-tumour tissue to ensure all of the tumor has been removed, and this often requires the patient to be under general anaesthesia. This is followed by what’s called “rapid-cut diagnosis” – the pathologist examines the material immediately under the microscope and informs us 1–2 hours after removal whether the cut edges are free of tumour. Subsequently, the reconstruction of the lid takes place on the same day in a second operation.

Lid reconstruction

The next step is lid reconstruction. There are a variety of surgical options available to do this, and in general, eyelid reconstruction has made tremendous progress over the past two decades. 

In the past, large skin transplants from the middle of the face were used to replace one or even both eyelids – and sometimes eyes were removed altogether. Fortunately, thanks to improved techniques, this “radical” surgery is no longer used in most cases today.

These days, defects of all sizes, including the complete lid can be covered by material derived from near the eyelids. Which method is used depends on how much of the eyelid needed to be removed (or in other words, how big the defect needing to be covered is). Modern surgical techniques range from a direct closure, to skin grafts, muscle or connective tissue slices, which are taken from the upper / lower lid of the same side or the lids of the other, healthy eye.

In rare cases where more skin is necessary, this is taken from behind the ear.

In addition, some of the modern procedures require two rounds of surgery, where the lid is reconstructed and the eye can not be opened for about 10 days. This is followed by another (short) intervention to complete the reconstruction.

Results

The number one priority in this surgery is that the carcinoma is completely removed. Of course, attention is paid to cosmetic appearance, but the former is vital, the latter is not. For large tumours, it may be expected that the eyelid will not look exactly as it did before surgery even after successful surgery.

If a skin graft is needed, it’s worth noting that the graft may have a different shade than the surrounding skin.

 

Surveillance

Even after complete removal of the carcinoma, there is still the danger that it may recur years after the operation. Please be aware that in the first 3 years after the operation, we will need 6-month check-ups. Later, the time between check-ups can be increased.

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Augeninstitut ELZA
4.8
Based on 107 reviews
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Serena Fazio
Serena Fazio
11:15 06 Mar 22
I have been to the ELZA clinic to have surgery for my miopy, as my eyes were rejecting the contacts and I was tired of... wearing glasses. From the first preliminary visit, to the actual surgery and post-surgery care Dr. Hafezi and all his collaborators have been extremely professional, considerate and helpful. All the steps of the (very short!) surgery were thoroughly explained to me in order to be as calm as possible, together with the medication plan and precautions to be aware of so that my eyes could heal in the best way possible. By following their exact instructions, the healing process has been very successful and smooth, and after about one week I was able to see perfectly. I absolutely recommend this team and their expertise!read more
Robin A
Robin A
11:43 16 Feb 22
Top experts and professional team. Highly recommended
Thunder Shiviah
Thunder Shiviah
14:05 23 Nov 21
After some research on local options I decided to go with ELZA since it stood out as the best. The operation and the... post-operation recovery went extremely smooth (something I was worried about with PRK). Now my vision is much better than I had hoped and I have no side effects such as dry eye or night vision problems. Thank you!read more
Squitieri Elias
Squitieri Elias
12:43 08 Sep 21
Die Behandlungen waren bei mir erfolgreich, alle waren sehr nett und haben mein Leben vereinfacht.Danke
Eliane Bossart
Eliane Bossart
13:01 05 Sep 21
Vor einem Jahr war ich einer ganz verzweifelten Situation und total im Stich gelassen. Meine Augen wurden aufgrund... eines ausgeprägten Kerakotonus immer schlechter, ich hatte Angst und war alleine mit meinen Problemen. Zudem vertrug ich die Kontaktlinsen nur noch ganz schlecht und hatte jeden Tag Schmerzen.Professor Hafezi hat mir mit zwei Operationen wieder das auf Grund der Situation mögliche an Lebensqualität zurückgebracht. Es war ein starpaziöses Jahr mit vielen Entbehrungen aber es hat sich gelohnt! Herzlichen Dank fuer die Unterstützung.read more
Gabriela Meyer
Gabriela Meyer
18:32 22 Aug 21
Ich wurde von meiner Optikerin auf Prof. Dr. Dr. Hafezi aufmerksam gemacht. Es war mir vorher nicht bewusst, dass meine... Augenkrankheit (Keratokonus) operativ mittels Cross Linking behandelt und so gestoppt werden kann. Die Beratung und Behandlung war sehr kompetent und ich fühlte mich jederzeit wohl. Die Operation verlief gut und das Ergebnis ist einwandfrei.read more
Naomi
Naomi
11:38 11 Aug 21
Ich bin sehr glücklich, dass ich das Elza Institute gefunden habe. Ich wurde von anderen Augenärzten abgewiesen, da... meine Augen zu kompliziert/schwierig zu behandeln waren. Prof. Dr. Dr. Hafezi konnte mir jedoch helfen und ich bin sehr glücklich und zufrieden mit dem Resultat. Vielen Dank!read more
Till B
Till B
08:30 19 Jul 21
Ich habe eine überaus kompetente Beratung und Behandlung erlebt. Die gesamte Betreuung war sehr freundlich und... professionell. Herzlichen Dank!read more
Thomas S.
Thomas S.
09:37 07 Jul 21
My left eye had to be operated on because of a cataract. As I had an Artiflex lens implanted a few years ago, it had to... be removed first before a modern lens could be implanted to correct the cataract. Prof. Hafezi treated me in an very competent and friendly manner. I am very happy with the result.read more
Selma A. Rahim
Selma A. Rahim
19:45 02 Jul 21
Dr. Hafezi.. the KING OF CXL🤴
Gianluca Ricci
Gianluca Ricci
12:46 10 Apr 21
Great team and service!
rehaneyecare
rehaneyecare
05:36 08 Apr 21
Excellent surgeon
Steven H.A
Steven H.A
16:13 11 Jan 21
Prof. F. Hafezi s expertise is enormous and he has a very pleasant and calm nature which gives the patient... security.Thank youread more
Online Commande
Online Commande
09:19 05 Dec 20
Totally creepy, very arrogant Prof.He just want your money.It may explain, why this Prof. is not in the center of the... city of Zürich and why he has been thrown away from University of Geneva.read more
Elena Churilova
Elena Churilova
10:06 17 Nov 20
At the moment, 3 months have passed since the moment I made laser vision correction in this clinic. and I can say that... I am happy that I chose this particular clinic and Prof. F. Hafezi. The entire staff of the clinic is very friendly, treats patients with sympathy and patience if they are nervous before surgery (my big gratitude to Aida Alili for all support and patience). The doctor Hafezi and other doctors of the clinic are very professional and ready to explain to you as many times as you need. I can only recommend!read more
Ashley Faulkes
Ashley Faulkes
15:30 21 Mar 16
Professor Hafezi and the team at the ELZA Institute have done an amazing job of creating a first class eye clinic, with... cutting edge technology and support. I went there for a dry eye issue and other issues with my prescription, and they were easily able to help me and put me on the road to better vision! High recommend them to anyone in the Zurich/Aargau area.read more
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Augeninstitut ELZA
4.8
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