|Year : 2017 | Volume
| Issue : 3 | Page : 484-486
Profile of eyelid malignancy in a Tertiary Health Care Center in North India
Priyanka Gupta1, Ramesh Chandra Gupta1, Lubna Khan2
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 Publication||31-Aug-2017|
109/397, Nehru Nagar, Kanpur - 208 012, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
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
| > Introduction|| |
Eyelid tumors are encountered by all ophthalmologists. Although the incidence of eyelid malignancies is increasing,,,,, 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.,, However, case series reported from Asian countries have shown a generally higher prevalence of SGC.,,,,
Present study was undertaken to observe the incidence of extraocular tumors in North India and correlate the findings with global data.
| > Subjects and Methods|| |
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.
Prospective, longitudinal, observational study was conducted from December 2011 to October 2013.
The patients attending Outpatient Department of Ophthalmology with mass or growth involving eyelid and willing to undergo surgery were included in the study.
- Secondaries from other tumors in the body
- Patients of extraocular tumor not willing to undergo surgery.
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|| |
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].
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].
| > Discussion|| |
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., 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.
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. 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. Sebaceous gland carcinoma (~37%) was observed to be almost as prevalent as BCC (~44%) in Central India. It is thus observed that the incidence of sebaceous gland carcinoma has a geographical variation and is more common in the Asian population.,, 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|| |
Interesting geographical variation was observed in trends of malignant eyelid tumors as sebaceous gland carcinoma was found to be most common variety.
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Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2]