Malignant tumours

The appropriate management of malignant eyelid tumours requires an understanding of their clinical and pathologic characteristics. Malignant tumours affecting the eyelids are generally slowly enlarging, destructive lesions that distort or frankly destroy eyelid anatomy. Subtle features can help to differentiate malignant from benign eyelid tumours (Box 6.1). Early diagnosis can significantly reduce morbidity and indeed mortality associated with malignant eyelid tumours. However, malignant eyelid tumours are diagnosed early only if a high degree of clinical suspicion is applied to all eyelid lesions.

Slit lamp examination can highlight these various features that help to differentiate benign from malignant tumours (Figure 6.1).

Figure 6.1 Eyelid BCC showing the malignant features of loss of lashes, obliteration of eyelid margin and pearly telangiectatic change.

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