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LIDS/LASHES/LACRIMAL ANOMALIES > LIDS - MALIGNANT EYELID TUMORS > Flashcards

LIDS - MALIGNANT EYELID TUMORS Flashcards

1
Q

what is the most common malignant eyelid tumor?

A

basal cell carcinoma (BCC)

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2
Q

what is the 2nd most common malignant eyelid tumor?

A

squamous cell carcinoma (SCC)

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3
Q

risk factors for both BCC & SCC?

A
  • elderly
  • fair skin (caucasions
  • UV exposure
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4
Q

what is the location of prevalence for BCC & SCC (in order of most common to least common)

A

lower lid > medial canthus > upper lid > lateral canthus

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5
Q

what are the 3 types of BCC?

A
  • Nodular
  • Nodulo-ulcerative
  • Morpheaform (sclerosing)
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6
Q

signs for nodular BCC

A
  • Shiny firm pearly nodule w/ dilated surface
    vessels (telangiectatic vessels).
  • Initially very slow growing
  • May develop an ulcer → Nodulo-ulcerative.
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7
Q

signs for nodulo-ulcerative (rodent ulcder) BCC

A
  • Increasing radial growth – leads to central ulceration (rodent ulcer).
  • Border will be indurated and seem to “roll over.”
  • Dilated vessels at margins.
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8
Q

signs for sclerosing BCC

A
  • **Indurated plaque **
  • Margins difficult to delineate.
  • Looks like chronic blepharitis.
  • Lateral infiltration beneath the epidermis
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9
Q

tx for BCC

A
  • full thickness excision with biopsy
  • Rec use of sun protection
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10
Q

what is the precursor for SCC?

A

actinic keratosis

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11
Q

how does actinic keratosis appear?

A

scaly, round erythematous lesion on eyelid

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12
Q

what is the most common precancerous skin lesion?

A

actinic keratosis

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13
Q

what lesion can appear similar to SCC?

A

keratocanthoma

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14
Q

how to ddx btwn keratocanthoma and SCC

A
  • Rapid growing lesion (double in size in a few weeks) that is usually found on sun exposed areas and has an appearance like SCC and BCC.
  • Spontaneous shrinkage –> complete resolution w/in 1yr.
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15
Q

signs of SCC

A
  • Scaly, painless, crusty or ulcerated plaque/nodule
  • May be flat or elevated.
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16
Q

tx for SCC

A
  • full thickness excision with biopsy
  • cryotherapy can be used to tx
  • Rec sun protection
17
Q

BCC vs SCC?

A
  • SCC will NOT have a pearly translucent border or telangiectatic vessels
18
Q

what should you suspect if a patient keeps returning with a recurring chalazion in the same location or chronic unilateral blepharitis?

A

sebaceous cell carcinoma

19
Q

define sebaceous cell carcinoma

A
  • A neoplasm of the sebaceous glands of the eyelids (MG & Zeis).
20
Q

who gets sebaceous cell carcinoma?

A

M>F who are >50 years or older

21
Q

what factors increase pt’s risk of mortality in sebaceous cell carcinoma?

A
  • If the lid tumor is greater than 2cm.
  • If symptoms have been present longer than 6 months
  • If there is superior and inferior lid involvment
22
Q

signs of sebaceous cell carcinoma

A
  • Immobile, yellowish (due to presence of lipid) , rock hard tumor (more common on superior lid).
  • Madarosis
  • Poliosis
  • Thickened red lid margin
23
Q

tx for sebaceous cell carcinoma

A

full thickness excision with biopsy

24
Q

what is the most lethal primary skin tumor?

A

malignant melanoma but it rare – accounting for 1% of all eyelid tumor

25
Q

tx for malignant melanoma

A
  • full thickness excision with biopsy
  • orbital exenteration with neck dissection – in severe cases
  • Red sun protection
  • refer to dermatology
26
Q

signs of malignant melanoma?

A
  • A - asymmetric
  • B - border irregular
  • C - color uneven
  • D - diameter large (>6)
  • E - enlarging & elevated
27
Q

what is kaposi sarcoma? what is it associated with?

A
  • vascular tumors typically associated with AIDS!
28
Q

signs of kaposi sarcoma?

A
  • Pink or red to violet lesion
  • May be found any number of places
    o Face
    o Eyelids
    o Conjunctiva
    o Mouth
29
Q

list the tumors worse to least bad

A

melanoma > sebaceous > squamous > basal cell

30
Q

what is capillary hemangioma?

A
  • it is the most common benign orbital tumor in children
    *
31
Q

signs of capillary hemangioma?

A
  • onset first month of life
  • superificial vascular lesion (strawberry nevus) with rapid growth.
  • possible amblyopia – if they block visual axis or press on the cornea & induce astigmatism
32
Q

tx fro capillary hemangioma?

A
  • spontaneously resolve/disapear by the time patients turns 10

LIDS/LASHES/LACRIMAL ANOMALIES (3 decks)

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