Tumores malignos palpebrais

A palavra "tumor" pode ser uma palavra assustadora para as pessoas ouvirem - muitos pacientes veem "tumor" como sendo sinônimo de "câncer maligno". É importante não confundir os dois termos.

A primeira distinção a ser feita é a diferença entre um inchaço inflamatório na área das pálpebras e "mais tecido". O tecido da pálpebra é delicado e uma leve inflamação pode levar a um inchaço maciço, e pode haver muitas causas desta inflamação, incluindo uma glândula lacrimal inflamada ou uma infecção causada por uma pequena lesão.

Se existe um verdadeiro "tecido extra" (como de um tumor), então frequentemente se trata de mudanças benignas, como um grão de cevada encapsulado, uma verruga, ou um chamado "molusco contagioso", causado por um vírus inofensivo, mas contagioso.

Entretanto, vários tumores malignos (carcinomas) de fato ocorrem nas pálpebras. O tumor maligno das pálpebras mais comum é o carcinoma basocelular (90%), seguido pelo carcinoma espinocelular (~5%) e carcinomas sebáceos (~5%). Em todos os casos, os tumores malignos suspeitos devem ser tratados rapidamente. Se necessário, consultaremos especialistas de outras disciplinas, como internistas, dermatologistas ou oncologistas (especialistas em câncer).

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.

A operação

Biópsia

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.
Para tumores grandes, o tumor é excisado, com uma região adicional do que parece ser tecido não tumoral para garantir que todo o tumor foi removido, e isto muitas vezes requer que o paciente esteja sob anestesia geral. Isto é seguido pelo chamado "diagnóstico rápido" - o patologista examina o material imediatamente sob o microscópio e nos informa 1-2 horas após a remoção se as bordas cortadas estão livres de tumor. Em seguida, a reconstrução da pálpebra é feita no mesmo dia, em uma segunda operação.

Reconstrução de pálpebras

O próximo passo é a reconstrução da pálpebra. Há uma variedade de opções cirúrgicas disponíveis para fazer isto e, em geral, a reconstrução das pálpebras fez um tremendo progresso nas últimas duas décadas. 

No passado, grandes transplantes de pele do meio do rosto eram usados para substituir uma ou mesmo as duas pálpebras - e às vezes os olhos eram completamente removidos. Felizmente, graças às técnicas melhoradas, esta cirurgia "radical" não é mais utilizada na maioria dos casos hoje em dia.

Atualmente, defeitos de todos os tamanhos, incluindo da pálpebra completa, podem ser cobertos por material próximo às pálpebras. Qual método irá ser utilizado depende de quanto da pálpebra precisava ser removida (ou, em outras palavras, do tamanho do defeito que precisa ser coberto). As técnicas cirúrgicas modernas variam de um fechamento direto, a enxertos de pele, cortes de músculo ou de tecido conjuntivo, que são retirados da pálpebra superior / inferior do mesmo lado ou das pálpebras do outro olho saudável.

Em casos raros em que se necessita de mais pele, esta é retirada de trás da orelha.

Além disso, alguns dos procedimentos modernos exigem dois turnos de cirurgia, onde a pálpebra é reconstruída e o olho não pode ser aberto por cerca de 10 dias. Isto é seguido por outra (curta) intervenção para completar a reconstrução.

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
Como base em 109 críticas
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mike
mike
09:02 04 Jan 23
Overall as a 50 year old, who wanted to continue to avoid wearing glasses and/or contact lenses, my goal was 100%... achieved with ELZA and Dr. Hafezi. I greatly appreciated the overall approach by Dr. Hafezi and his friendly and competent team in reviewing my vision at the start and following a comprehensive eye exam- the explanations of my options. For me I chose PRK in one eye for a monovision solution to correct short sightedness which was becoming more prevalent in night driving and sports such as skiing and cycling. PRK heals slowly but the outcome is worth the wait- and the cost- you use your eyes every waking moment- and for me I cannot see any reason not to pursue better vision with the ELZA team! A great quality of life enhancement!ler mais
Zuzana Fecko
Zuzana Fecko
21:48 31 Oct 22
Thank you so much, Dr. Torres and prof. Hafezi. 26 years I was only “dreaming” about the eye surgery due to possible... complications. I was worried ..Thank you for encouraging me to make a decision and thank you for your professionalism, explanations and great work!I wish you all the best, lots of success and only happy patients!ler mais
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!ler mais
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!ler mais
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.ler mais
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 youler mais
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.ler mais
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!ler mais
Michele Aggiato
Michele Aggiato
18:17 10 Jan 20
The day I had Prof Hafezi checking my keratoconus I knew I was finally in the right place after years of searching for... a good ophthalmologist. Prof Hafezi recommended a surgery due to a drastic degeneration of my cornea. The surgery was performed by himself with the assistance of Dr Rodriguez, one more collaborator of Prof Hafezi’s team who got my full trust.ler mais
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.ler mais
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Augeninstitut ELZA
4.8
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