Home About us Editorial board Ahead of print Current issue Search Archives Submit article Instructions Subscribe Contacts Login 

 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 13  |  Issue : 3  |  Page : 484-486

Profile of eyelid malignancy in a Tertiary Health Care Center in North India


1 Department of Ophthalmology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
2 Department of Pathology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India

Date of Web Publication31-Aug-2017

Correspondence Address:
Priyanka Gupta
109/397, Nehru Nagar, Kanpur - 208 012, Uttar Pradesh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.183215

Rights and Permissions
 > Abstract 

Context: The eyelids are affected by wide spectrum of benign and malignant lesions. Basal cell carcinoma (BCC) is the most common malignancy encountered while other malignant lesions such as sebaceous cell carcinoma and squamous cell carcinoma are rare. Data regarding geographical variation in trends of malignant eyelid tumors are presented in the current study.
Settings and Design: Prospective, longitudinal, observational study was conducted from December 2011 to October 2013.
Subjects and Methods: Patients with mass or growth involving eyelid managed by surgical intervention were selected for the study. Excised tissue masses were sent for histopathological examination.
Results: Fifty-two cases of extraocular tumors were operated during the study period, out of which 25 cases (48%) were of eyelids. Sixteen cases (64%) were benign, and remaining 9 cases (36%) were malignant eyelid neoplasms. Benign lesions exhibited female preponderance with male:female ratio of 1:2.25. No significant difference was noted in cases of malignant lesions with male:female ratio of 1:1.25. Most common benign tumor observed was sebaceous cyst. Sebaceous gland carcinoma (4 cases) was the most common malignant neoplasm followed by squamous cell carcinoma (2 cases) and BCC, orbital melanoma, and adenocarcinoma (1 case each).
Conclusions: Sebaceous gland carcinoma is more common in North India as compared to BCC and squamous cell carcinoma.

Keywords: Eyelid, malignancy, pathology


How to cite this article:
Gupta P, Gupta RC, Khan L. Profile of eyelid malignancy in a Tertiary Health Care Center in North India. J Can Res Ther 2017;13:484-6

How to cite this URL:
Gupta P, Gupta RC, Khan L. Profile of eyelid malignancy in a Tertiary Health Care Center in North India. J Can Res Ther [serial online] 2017 [cited 2020 Jun 4];13:484-6. Available from: http://www.cancerjournal.net/text.asp?2017/13/3/484/183215


 > Introduction Top


Eyelid tumors are encountered by all ophthalmologists. Although the incidence of eyelid malignancies is increasing,[1],[2],[3],[4],[5] their global distribution is varied and remains undercharacterized.

It is reported that 90% of the malignant eyelid tumors are basal cell carcinomas (BCC) while other malignant forms such as sebaceous gland cell carcinoma (SGC) and squamous cell carcinoma (SCC) are rare.[3],[4],[6] However, case series reported from Asian countries have shown a generally higher prevalence of SGC.[1],[2],[4],[5],[7]

Present study was undertaken to observe the incidence of extraocular tumors in North India and correlate the findings with global data.


 > Subjects and Methods Top


Ethics

Ethical approval for this study (notice no. 52 (A)/ND/2013) was provided by the Ethics Committee on June 15, 2013. The study was conducted as per guidelines of the Declaration of Helsinki. Informed consent was obtained from the study participants, and their identity has not been disclosed in any form.

Study design

Prospective, longitudinal, observational study was conducted from December 2011 to October 2013.

Inclusion criteria

The patients attending Outpatient Department of Ophthalmology with mass or growth involving eyelid and willing to undergo surgery were included in the study.

Exclusion criteria

  1. Secondaries from other tumors in the body
  2. Patients of extraocular tumor not willing to undergo surgery.


Methodology

Comprehensive history was recorded and physical examination was performed. Preoperative investigations were done such as complete blood count, random blood sugar, bleeding time, clotting time, HIV and hepatitis B Surface antigen status, and X-ray/computed tomography scan/magnetic resonance imaging head and orbit as per requirement.

All patients underwent surgical management. Excisable tumors were subjected to excisional biopsies, whereas incisional biopsies were taken from advanced malignant tumors which were rendered inoperable due to their size or depth. All biopsies were submitted for histopathological examination, and cases were followed at regular interval to rule out recurrences. Patients were followed up for a minimum period of 3 months. Data collected were analyzed, and conclusion was drawn at the end of the study.


 > Results Top


Out of total 52 cases of extraocular tumors operated, 25 cases (48%) of eyelid masses were encountered.

Sixteen cases (64%) were benign while the remaining 9 cases (36%) were malignant benign lesions were more common in females (11 cases) with male:female ratio of 1:2.5, while no significant difference was seen in malignant tumors with male:female ratio of 1:1.25.

Most common benign eyelid lesions were sebaceous cyst (3 cases, 18.8%) followed by dermoid, nevus, capillary and cavernous hemangioma, fibroepithelial polyp (2 cases, 12.5% each) and papilloma, abscess, plexiform neurofibroma (1 case, 6.25% each) [Table 1].
Table 1: Histopathological profile among benign eyelid tumors

Click here to view


In the malignant eyelid lesion group, there were 4 males and 5 females. Sebaceous gland carcinoma (44.4%) was the predominant malignant eyelid tumor followed by squamous cell carcinoma (22.2%) and BCC (11.1%) [Table 2].
Table 2: Histopathological profile among malignant eyelid tumors

Click here to view



 > Discussion Top


As per the literature, BCC is the most common malignant tumor of the eyelids in France and other European countries and constitutes 85–90% of all malignant epithelial eyelid tumors.[8],[9] Although squamous cell carcinoma is 40 times less common than BCC, it is more common on the upper eyelid and lateral canthus in comparison to BCC. Squamous cell carcinoma was found to be the most common tumor (65%) among the elderly persons in Nepal.[10]

Sebaceous gland carcinoma is a highly malignant neoplasm that arises from  Meibomian gland More Detailss, glands of Zeis, and the sebaceous glands of caruncle and eyebrow. It is the third most common eyelid malignancy accounting for 15.5% of all eyelid cancers.[11] Recent studies from India and China have shown that sebaceous gland carcinoma accounts for 33–60% of malignant eyelid tumors. In China, the tumor is reported to occur in 28% of the lid cancers.[12] Sebaceous gland carcinoma (~37%) was observed to be almost as prevalent as BCC (~44%) in Central India.[13] It is thus observed that the incidence of sebaceous gland carcinoma has a geographical variation and is more common in the Asian population.[6],[14],[15] This fact has been supported by our study also. Sebaceous gland carcinoma (4 cases, 44.4%) was the predominant malignant tumor followed by squamous cell carcinoma (2 cases, 22.2%) and BCC, orbital melanoma, and adenocarcinoma (1 case each, 11.1%) among malignant eyelid tumors. Higher incidence of sebaceous gland carcinoma can be attributed to oily nature of the skin among Indians. Decline in basal cell and squamous cell carcinoma can be due to more melanin in Indian population which provides protection from sunlight.


 > Conclusion Top


Interesting geographical variation was observed in trends of malignant eyelid tumors as sebaceous gland carcinoma was found to be most common variety.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
 > References Top

1.
Abdi U, Tyagi N, Maheshwari V, Gogi R, Tyagi SP. Tumours of eyelid: A clinicopathologic study. J Indian Med Assoc 1996;94:405-9, 416, 418.  Back to cited text no. 1
    
2.
Abe M, Ohnishi Y, Hara Y, Shinoda Y, Jingu K. Malignant tumor of the eyelid – Clinical survey during 22-year period. Jpn J Ophthalmol 1983;27:175-84.  Back to cited text no. 2
    
3.
Al-Buloushi A, Filho JP, Cassie A, Arthurs B, Burnier MN Jr. Basal cell carcinoma of the eyelid in children: A report of three cases. Eye (Lond) 2005;19:1313-4.  Back to cited text no. 3
    
4.
Shields JA, Demirci H, Marr BP, Eagle RC Jr., Shields CL. Sebaceous carcinoma of the eyelids: Personal experience with 60 cases. Ophthalmology 2004;111:2151-7.  Back to cited text no. 4
    
5.
Wang JK, Liao SL, Jou JR, Lai PC, Kao SC, Hou PK, et al. Malignant eyelid tumours in Taiwan. Eye (Lond) 2003;17:216-20.  Back to cited text no. 5
    
6.
Ni C, Searl SS, Kuo PK, Chu FR, Chong CS, Albert DM. Sebaceous cell carcinomas of the ocular adnexa. Int Ophthalmol Clin 1982;22:23-61.  Back to cited text no. 6
    
7.
Sihota RK, Tandon SM, Betharia SM, Arora R. Malignant eyelid tumors in an Indian population. Arch Ophthalmol 1996;114:108-9.  Back to cited text no. 7
    
8.
Allali J, D'Hermies F, Renard G. Basal cell carcinomas of the eyelids. Ophthalmologica 2005;219:57-71.  Back to cited text no. 8
    
9.
Margo CE, Waltz K. Basal cell carcinoma of the eyelid and periocular skin. Surv Ophthalmol 1993;38:169-92.  Back to cited text no. 9
    
10.
Font RL. Eyelids and lacrimal drainage system. In: Spencer WH, editor. Ophthalmic Pathology: An Atlas and Textbook. 4th ed., Vol. 4. Philadelphia: WB Saunders; 1996. p. 2218-433.  Back to cited text no. 10
    
11.
Kumar R, Adhikari RK, Sharma MK, Pokharel DR, Gautam N. Pattern of ocular malignant tumors in Bhairahwa, Nepal. Int J Ophthalmol Vis Sci 2009;7:1.  Back to cited text no. 11
    
12.
Ni C, Kuo PK. Meibomian gland carcinoma. A clinicopathological study of 156 cases with long period follow-up of 100 cases. Jpn J Ophthalmol 1979;23:388-401.  Back to cited text no. 12
    
13.
Jahagirdar SS, Thakre TP, Kale SM, Kulkarni H, Mamtani M. A clinicopathological study of eyelid malignancies from central India. Indian J Ophthalmol 2007;55:109-12.  Back to cited text no. 13
[PUBMED]  [Full text]  
14.
Maheshwari R, Maheshwari S, Shekde S. Role of fine needle aspiration cytology in diagnosis of eyelid sebaceous carcinoma. Indian J Ophthalmol 2007;55:217-9.  Back to cited text no. 14
[PUBMED]  [Full text]  
15.
Shields JA, Demirci H, Marr BP, Eagle RC Jr., Shields CL. Sebaceous carcinoma of the ocular region: A review. Surv Ophthalmol 2005;50:103-22.  Back to cited text no. 15
    



 
 
    Tables

  [Table 1], [Table 2]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

  >Abstract>Introduction>Subjects and Methods>Results>Discussion>Conclusion>Article Tables
  In this article
>References

 Article Access Statistics
    Viewed1568    
    Printed56    
    Emailed0    
    PDF Downloaded160    
    Comments [Add]    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]