Malignant Tumors

Question 1

Melanoma

• What is it
• Cause

Answer 1

Malignant Tumor of the skin

Proliferation of atypical melanocytes associated with UV exposure

Question 2

Melanoma
Demographics
Laterality

Answer 2

More common in caucasians

Unilateral

Question 3

Melanoma

Symptoms and signs

Answer 3

Symptoms- Asymptomatic, bump on eyelid
Signs- Variable appearance. Flat or slightly raised and discolored, asymmetrical patch with uneven borders.

Asymmetry
Indistinct borders
Various colors 
6mm diameter or larger 
Evolving- change in size or shape. New mole after 40.

Question 4

Melanoma

Complications

Answer 4

Metastasis, strong propensity

Question 5

Melanoma

Management

Answer 5

Surgical excision/biopsy

Question 6

Least common eyelid malignancy
BUT
Most dangerous eyelid malignancy due to metastasis

Answer 6

Melanoma.
Represents 1% of all eyelid tumors.

Accounts for the majority of skin cancer death.

5 Year survival rate is 99% if treated prior to metastasis.
62% if it travels to LN
20% if it travels to organs

Question 7

Basal Cell Carcinoma
What is it
Cause

Answer 7

Malignant tumor of the skin

Proliferation of atypical basal epithelial cells. Associated with UV exposure

Question 8

Basal Cell Carcinoma
Demographics
Laterality

Answer 8

Typically develops after age of 50. More common in caucasians.

Unilateral

Question 9

Basal Cell Carcinoma
Symptoms
Signs

Answer 9

Asymptomatic, bump on eyelid.

Variable appearance- pink, shiny, firm, pearly nodule with small overlying blood vessels. Centrally ulcerated with pearly raised edges. Firm, waxy yellow plaque with indistinct borders. Open sore.
ABCDE

Question 10

Basal Cell Carcinoma

Most frequently involves which part of the lid

Answer 10

LL > Medial canthus > UL > Lateral canthus

Question 11

Basal Cell Carcinoma

Complications

Answer 11

Orbital extension, metastasis is extremely rare.

Question 12

Basal Cell Carcinoma

Management

Answer 12

Surgical excision and biopsy

Question 13

Most common skin cancer

Answer 13

Basal Cell Carcinoma

90% occur on head and neck. 10% of those involve the eyelid.

Question 14

Most common eyelid cancer. Accounts for __%

Answer 14

Basal Cell Carcinoma

90%

Question 15

Squamous Cell Carcinoma

• What is it
• Cause

Answer 15

Malignant tumor of the skin.

Proliferation of atypical squamous epithelial cells associated with UV exposure.

Question 16

Squamous Cell Carcinoma
Demographics
Laterality

Answer 16

Develops after age 50
More common in caucasians

Unilateral

Question 17

Squamous Cell Carcinoma
Symptoms
Signs

Answer 17

Symptoms- Asymptomatic, bump on eyelid.

Signs- Variable appearance, scaly red patch. May have crusting or blood margins.
Rough, thickened, or wart like. Raised growth with central depression. Open sore.
ABCDE

Question 18

Squamous Cell Carcinoma frequently involves which lid

Answer 18

LL

Question 19

Squamous Cell Carcinoma
Complications
Management

Answer 19

Orbital extension, metastasis.

Management- Surgical excision and biopsy.

Question 20

2nd most common skin cancer

2nd most common eyelid cancer

Answer 20

Squamous Cell Carcinoma

Accounts for 5-10% of eyelid cancer cases

Question 21

majority of Squamous Cell Carcinomas arise from

Answer 21

Actinic Keratosis

Often appear as small, dry, scaly or crusty patches of skin. Feel dry and rough. Painful, itchy, burning.

Question 22

5-10% of Actinic Keratosis transform into

Answer 22

Squamous Cell Carcinoma

Question 23

Variant of Squamous Cell Carcinoma

Answer 23

Keratoacanthoma.
Clinically may resemble SCC and BCC.

Rapid growth over a few weeks to months followed by slow regression and even spontaneous resolution in 4-6 months.

Question 24

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma

• What is it
• cause

Answer 24

Malignant tumor of the sebaceous gland.

Proliferation of atypical epithelial cells lining sebaceous glands.

Question 25

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma Demographics Laterality

Answer 25

Typically develops after the age of 50 | Unilateral

Question 26

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma Symptoms Signs

Answer 26

Asymptomatic, bump on lid Variable appearance- Discrete hard nodule that may exhibit yellow discoloration due to the presence of lipid. May resemble benign lesions such as a recurrent chalazian, hordeolum, and blepharitis. Spreads along the conj surface.

Question 27

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma most frequently involves with lid

Answer 27

UL

Question 28

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma | Complications and management

Answer 28

Orbital Extension, metastasis Surgical excision and biopsy

Question 29

Sebaceous Gland Carcinoma/Meibomian Gland Carcinoma Represents __% of all eyelid tumors Overall mortality is __ due to metastasis

Answer 29

less than 1% | 5-10% mortality

Question 30

Kaposi's Sarcoma - What is it - Cause

Answer 30

Malignant tumor that usually appears on the skin or mucosal surfaces. Skin lesions most often affect the legs and face. Proliferation of endothelial cells that line lymph or BV in response to capos sarcoma associated herpesvirus.

Question 31

Kaposi's Sarcoma - Demographics - Laterality

Answer 31

4 types defined by the populations that acquire KS- AIDS associated, Mediterranean, African, Transplant related. Unilateral or bilateral

Question 32

Kaposi's Sarcoma Symptoms Signs

Answer 32

Symptoms- Asymptomatic, bump or plaque on eyelid. Signs- Purple, red, or brown nodule or plaque. Can occur on the eyelid or conj. ABCDE

Question 33

Kaposi's Sarcoma | Management

Answer 33

Refer out for treatment. - HAART - no improvement? Surgical resection. No cure. Purpose of therapy is directed at improving cosmoses and slowing progression.

Question 34

Kaposi's Sarcoma is considered an ____ illness

Answer 34

AIDS defining