The main treatment for a majority of eyelid tumors involves surgical excision or other types of surgical removal.
The surgical procedure that is chosen depends on the cancer type and the characteristics of the tumor. For instance, squamous cell carcinomas involve excising a more significant margin as well as adjuvant therapy in comparison to basal cell carcinomas.
The tumor characteristics will include:
- Primary or recurrent tumor
Oculoplastic surgeon Dr. Jennifer Hui provides a wide range of cosmetic, medical and surgical eye care procedures to patients in Palm Springs, Palm Desert, La Quinta, Coachella Valley, Riverside, Redlands, Yucaipa, Loma Linda, and surrounding communities.
This type of resection involves the full removal of the tumor along with a healthy tissue margin. The margin’s size can vary between 3 to 15 mm depending on the tumor’s grade and associated risks. Local resection with a margin is appropriate for tiny tumors with low recurrence risks, metastasis or local spread.
This is usually the only procedure required other than in the case of melanoma. The patient will not require any further therapy if the excisional biopsy effectively eliminates the entire tumor. While the surgeon typically performs this procedure on an outpatient basis, they may perform it in a hospital using local anesthesia.
Following tumor excision, it is sent to a pathologist for histopathologic examination. The patient may require wound closure or eyelid reconstruction, and this will depend on the tumor’s size. The scar typically fades away over time.
This procedure is also known as Mohs micrographic surgery. It offers the highest cure rates among all surgical procedures. The surgeon usually performs this procedure using local anesthesia and on an outpatient basis.
The surgeon will excise the tumor with a narrow layer of tissue surrounding it. They will temporarily bandage the wound and mark the sample for further investigation. Following this, the surgeon takes the sample to the histopathology lab for a complete tissue exam under a microscope to ensure that the margin is cancer-free.
This sample is mapped to the eyelid. This ensures that the surgeon can precisely understand the location of any tumor cells and perform a more in-depth excision procedure at that specific site.
The process is repeated as required till the margins do not display any more tumor cells. This excision technique preserves the maximum amount of normal tissue while ensuring that all malignant tissue is eliminated. But this procedure is not undertaken at all centers. The patient may require wound closure by primary or secondary intention, or they may need reconstruction of the eyelid.
Curettage and Electrodissection
This procedure involves the use of heat to ablate the malignant tumor tissue while closing off blood vessels. After this, the surgeon scrapes away the dead tissue. This technique is used to eliminate small (under 2 cm) basal cell carcinomas occurring near the surface, or in situ squamous cell carcinomas.
It is typically not performed for the removal of eyelid tumors due to the lack of tissue after an ablative procedure, and the high risk of recurrence. The surgeon performs this procedure using local anesthesia, and it does not involve any major disfigurement.