What are eyelid tumors?
Eyelid tumors are abnormal masses of cells that occur around the eyes. A tumor forms when the cells divide more than normal or don’t die when they should. The tumors can be benign (noncancerous) or malignant (cancerous). Some eyelid tumors may grow large but won’t spread to other parts of the body, while other types of growths can spread to nearby areas of the eye.
Eyelid tumors are diagnosed and treated by an ophthalmologist who specializes in the eye's function and diseases, or a dermatologist who specializes in skin conditions and diseases. If the diagnosis is cancer, your doctor may work with other specialists, such as an ocular oncologist who treats cancers of the eyelid or a surgeon who will remove the tumor, if necessary. Penn Medicine specialists are leading researchers in the diagnosis and treatment of ocular tumors. We are dedicated to offering the most advanced treatment options for even the most complex eye diseases like ocular melanoma and squamous cell carcinoma.
Eyelid tumor symptoms
Eyelid tumors often don't have any symptoms, but this can vary by the type of tumor. If your tumor is small, you may notice only mild irritation. If the growth is larger, it can press on the surface of the eye, interfering with your vision. In some cases, the following symptoms may indicate a tumor:
- Lump or growth
- Redness
- Pain
- Discharge
- Bleeding
- Itching
- Loss of eyelashes
- Erosion of the surrounding skin
Types of eyelid tumors
Tumors of the eyelid can be either cancerous or noncancerous, invasive or noninvasive.
The most common benign tumors of the eyelid include:
- Cyst (chalazion): This growth forms slowly when an oil gland gets blocked. It looks like a red bump, usually on the upper eyelid but can also form on the lower eyelid. It might hurt at first, but the pain goes away quickly.
- Stye (hordeolum): Caused by a bacterial infection in an oil gland, a stye is often painful and creates a tender red bump either on the outside or inside edge of the eyelid.
- Eyelid nevus: These are freckles or moles that can be raised or flat, with or without color, and grow anywhere in the eyelid skin.
- Seborrheic keratosis: This is a common type of raised tumor that is round or oval, looks like a wart, and might bleed or itch. It can be confused with basal cell carcinoma or malignant melanoma.
- Papilloma: A painless growth that can be smooth or rough, one growth or multiple, and appear flesh-colored, pink, or dark brown. Their frequency increases with age.
Most malignant eyelid tumors are basal cell carcinomas. The types of malignant eyelid growths include:
- Basal cell carcinoma: The most common eyelid cancer, this type of tumor appears as a lump and grows slowly. It rarely spreads to other body parts, but it can grow deep into nearby soft tissues. This type of growth usually responds well to treatment.
- Squamous cell carcinoma: A more aggressive tumor of the outer skin layer, this type of growth can rapidly spread to the eye socket, lymph nodes, or other organs if not treated. However, if detected early and completely removed, the outcome can be positive.
- Sebaceous gland carcinoma: A rare tumor that develops in the oil glands of the eyelid. It can look like a stye or chronic eye inflammation.
- Malignant melanoma: A more aggressive type of eyelid tumor that can spread to nearby lymph nodes and other parts of the body.
What causes eyelid tumors?
Excessive exposure to sunlight increases the risk for developing skin cancer of the eyelids, this includes experiencing sunburns or using tanning beds. People with less melanin, the substance which gives color to skin, hair, and eyes, may sunburn more easily, increasing the risk of eyelid tumors. This group includes fair-skinned people with blue, green, or hazel eyes, as well as those with blond or red hair, who are more sensitive to UV radiation. However, even people with darker skin or hair can develop eyelid cancers. Additional risk factors include smoking, a history of skin cancer, or having multiple moles.
Other types of non-cancerous eyelid growths, like cysts or styes, can be caused by clogged oil glands or bacterial infections.
Diagnosing an eyelid tumor
To diagnose an eyelid tumor, your doctor will closely examine the eyelid using a dermatoscope with a special magnifying lens and light. Because malignant eyelid tumors may look like and grow from benign pre-malignant tumors, if they see a suspicious-looking growth, they may take a small sample of skin, called a skin biopsy, to confirm a diagnosis.
At Penn, we use various biopsy techniques and tumor mutation testing as appropriate. Our dermatopathologists (specialists in diagnosing skin diseases) examine the sample under a microscope for signs of melanoma. If a skin biopsy confirms melanoma of the eyelid, we may do further tests to see if the cancer has spread.
Eyelid tumor treatment
With an accurate diagnosis, your doctor will work closely with you to determine an effective care plan. Benign eyelid tumors, like cysts and styes, may go away on their own. Treatments can include warm compresses, a steroid injection (cyst), antibiotics (stye), or if the growth gets bigger, it may be removed with surgery. Eyelid nevi are usually harmless, but they can be removed for cosmetic reasons through surgery. Seborrheic keratoses and papillomas don’t typically require treatment. If they become irritated, your doctor may remove them using cryosurgery or a shave excision.
When caught early, basal cell and squamous cell skin cancers are almost always curable. Melanoma can also be cured if it is diagnosed and treated in its earliest stages. At Penn Medicine, we are experts at delivering the latest treatment options for eye tumors, including Mohs micrographic surgery, a highly skilled and precise surgical technique used to remove cancerous eyelid tumors.
Eyelid tumor disease prevention
When it comes to preventing and detecting eyelid tumors, the best approach is prevention. Avoid sun exposure during peak hours between 10 a.m. to 4 p.m. If you’re going to be out in the sun, wear a wide-brimmed hat and sunglasses, and use sunscreen with an SPF of 30 or more every day, even in winter. Reapply sunscreen every two hours or after swimming.
Early detection is vital to getting the best possible outcome. Check your eyelids once a month for growths and see a dermatologist every year.
Rated “exceptional” by The National Cancer Institute
Penn Medicine’s Abramson Cancer Center is a world leader in cancer research, patient care, and education. Our status as a national leader in cancer care is reflected in our continuous designation as a Comprehensive Cancer Center by the National Cancer Institute (NCI) since 1973, one of 7 such centers in the United States. The ACC is also a member of the National Comprehensive Cancer Network, one of a select few cancer centers in the U.S., that are working to promote equitable access to high-quality, advanced cancer care.