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Squamous Cell Carcinoma, Eyelid: Treatment & Medication

Author: Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Contributor Information and Disclosures

Updated: Feb 5, 2009

Treatment

Medical Care

  • All patients should be advised to protect their eyelids from sun exposure.
    • Physical sunblocks with the active ingredients of zinc oxide or titanium oxide provide the most complete protection from UVA and UVB rays.15
    • Alternatively, a combination chemical sunblock of octocrylene, ecamsule, and avobenzone also provides excellent broad-spectrum UV protection.16
  • If systemic metastasis is discovered, the patient should be referred to an oncologist for adjunctive chemotherapy.

Surgical Care

  • Complete excision of lesion
    • Mohs micrographical excision - Fresh tissue technique of Mohs has been advocated as the treatment of choice. Mohs reported a 5-year cure rate of 98.1% in 213 cases of eyelid squamous cell carcinomas that had been treated.17
    • Wide local excision with frozen-section monitoring of margins may be performed when Mohs micrographical excision is not readily available.11
  • Radiation therapy - For patients who are unwilling or medically unable to undergo an extensive excision of the lesion.18
  • Photodynamic therapy with 5-aminolevulinic acid (ALA) - For patients with discrete eyelid lesions who are unable or unwilling to undergo an extensive surgical excision of the lesion.8,19
  • Cryotherapy - For patients who refuse surgery or are poor surgical candidates
  • Orbital exenteration - In cases with secondary orbital invasion.11
Axial MRI of a large squamous cell carcinoma of t...

Axial MRI of a large squamous cell carcinoma of the left lower eyelid with invasion of the anterior orbit.

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Axial MRI of a large squamous cell carcinoma of t...

Axial MRI of a large squamous cell carcinoma of the left lower eyelid with invasion of the anterior orbit.


Consultations

  • Otolaryngologist, if regional lymph node metastasis is present and patient requires lymph node dissection and/or neck dissection
  • Oncologist, if systemic metastasis is present
  • Radiation oncologist, if patient is unable to undergo surgical excision of lesion and radiotherapy is desired

Activity

  • Protection from sunlight may significantly reduce risk of developing squamous cell carcinoma.
    • Use of sun block, wearing protective clothing, and avoiding excessive sun exposure should be recommended to all patients, especially fair-skinned elderly patients.
    • Even young patients should be advised to take precautions against excessive sun exposure to reduce risk of developing cutaneous malignancies in future.

More on Squamous Cell Carcinoma, Eyelid

Overview: Squamous Cell Carcinoma, Eyelid
Differential Diagnoses & Workup: Squamous Cell Carcinoma, Eyelid
Treatment & Medication: Squamous Cell Carcinoma, Eyelid
Follow-up: Squamous Cell Carcinoma, Eyelid
Multimedia: Squamous Cell Carcinoma, Eyelid
References
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References

  1. Cook BE Jr, Bartley GB. Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmstead County, Minnesota. Ophthalmology. Apr 1999;106(4):746-50. [Medline].

  2. Dailey JR, Kennedy RH, Flaharty PM, et al. Squamous cell carcinoma of the eyelid. Ophthal Plast Reconstr Surg. Sep 1994;10(3):153-9. [Medline].

  3. Thosani MK, Schneck G, Jones EC. Periocular squamous cell carcinoma. Dermatol Surg. May 2008;34(5):585-99. [Medline].

  4. Doxanas MT, Iliff WJ, Iliff NT, Green WR. Squamous cell carcinoma of the eyelids. Ophthalmology. May 1987;94(5):538-41. [Medline].

  5. Reifler DM, Hornblass A. Squamous cell carcinoma of the eyelid. Surv Ophthalmol. May-Jun 1986;30(6):349-65. [Medline].

  6. Kwitko ML, Boniuk M, Zimmerman LE. Eyelid tumors with reference to lesions confused with squamous cell carcinoma. I. Incidence and errors in diagnosis. Arch Ophthalmol. Jun 1963;69:693-7. [Medline].

  7. McCarty JH, Barry M, Crowley D, Bronson RT, Lacy-Hulbert A, Hynes RO. Genetic ablation of alphav integrins in epithelial cells of the eyelid skin and conjunctiva leads to squamous cell carcinoma. Am J Pathol. Jun 2008;172(6):1740-7. [Medline].

  8. Gilberg SM, Tse DT. Malignant eyelid tumors. Ophthalmol Clin. 5:261-85.

  9. Maclean H, Dhillon B, Ironside J. Squamous cell carcinoma of the eyelid and the acquired immunodeficiency syndrome. Am J Ophthalmol. Feb 1996;121(2):219-21. [Medline].

  10. Maurer TA, Christian KV, Kerschmann RL, et al. Cutaneous squamous cell carcinoma in human immunodeficiency virus- infected patients. A study of epidemiologic risk factors, human papillomavirus, and p53 expression. Arch Dermatol. May 1997;133(5):577-83. [Medline].

  11. Boyer JD, Sullivan TJ, Whitehead KJ, Kelly LE, Allison RW. The management of perineural spread of squamous cell carcinoma to the ocular adnexae. Ophthal Plast Reconstr Surg. 2003;19:275-281. [Medline].

  12. Donaldson MJ, Sullivan TJ, Whitehead KJ, Williamson RM. Squamous cell carcinoma of the eyelids. Br J Ophthalmol. 2002;86:1161-1165. [Medline].

  13. Faustina M, Diba R, Ahmadi MA, Esmaeli B. Patterns of regional and distant metastasis in patients with eyelid and periocular squamous cell carcinoma. Ophthalmology. 2004;111:1930-1932. [Medline].

  14. Howard GR, Nerad JA, Carter KD, Whitaker DC. Clinical characteristics associated with orbital invasion of cutaneous basal cell and squamous cell tumors of the eyelid. Am J Ophthalmol. Feb 15 1992;113(2):123-33. [Medline].

  15. Seite S, Colige A, Piquemal-Vivenot P. A full-UV spectrum absorbing daily use cream protects human skin against biological changes occurring in photoaging. Photodermatol Photoimmunol Photomed. Aug 2000;16(4):147-55. [Medline].

  16. Seite S, Moyal D, Richard S. Mexoryl SX: a broad absorption UVA filter protects human skin from the effects of repeated suberythemal doses of UVA. J Photochem Photobiol B. Jun 15 1998;44(1):69-76. [Medline].

  17. Mohs FE. Micrographic surgery for the microscopically controlled excision of eyelid cancers. Arch Ophthalmol. Jun 1986;104(6):901-9. [Medline].

  18. Rio E, Bardet E, Ferron C. Interstitial brachytherapy of periorificial skin carcinomas of the face: a retrospective study of 97 cases. Int J Radiat Oncol Biol Phys. Nov 1 2005;63(3):753-7. [Medline].

  19. Rossi R, Puccioni M, Mavilia L, Campolmi P, Mori M, Cappuccini A, et al. Squamous cell carcinoma of the eyelid treated with photodynamic therapy. J Chemother. 2004;16:306-309. [Medline].

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Further Reading

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Keywords

eyelid squamous cell carcinoma, eyelid skin cancer, eyelid malignancy, eyelid neoplasm, SCC, facial skin cancer, skin carcinoma, adenoacanthoma, adenoid squamous cell carcinoma, invasive squamous cell carcinoma, malignant squamous cell carcinoma, pseudoglandular squamous cell carcinoma, actinic keratosis, xeroderma pigmentosum, eyelid radiation therapy

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Contributor Information and Disclosures

Author

Michael T Yen, MD, Associate Professor of Ophthalmology, Department of Ophthalmology, Division of Ophthalmic Plastic, Lacrimal, and Orbital Surgery, Cullen Eye Institute, Baylor College of Medicine
Michael T Yen, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Cataract and Refractive Surgery, American Society of Ophthalmic Plastic and Reconstructive Surgery, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Medical Editor

Ron W Pelton, MD, PhD, Private Practice, Colorado Springs, Colorado
Ron W Pelton, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Colorado Medical Society, Utah Medical Association, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Simon K Law, MD, PharmD, Assistant Professor of Ophthalmology, Jules Stein Eye Institute; Chief of Section of Ophthalmology Surgical Services, Department of Veterans Affairs Healthcare Center, West Los Angeles
Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology
Disclosure: Nothing to disclose.

Managing Editor

Mark T Duffy, MD, PhD, Consulting Staff, Division of Oculoplastic, Orbito-facial, Lacrimal and Reconstructive Surgery, Green Bay Eye Clinic, BayCare Clinic; Medical Director, Advanced Cosmetic Solutions, A BayCare Clinic
Mark T Duffy, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Ophthalmic Plastic and Reconstructive Surgery, Sigma Xi, and Society for Neuroscience
Disclosure: Allergan - Botox Cosmetic Consulting fee Consulting; Quest medical - lacrimal balloons Honoraria Speaking and teaching; Ortho-Neutrogenia Consulting fee Consulting

CME Editor

Lance L Brown, OD, MD, Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri
Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD, Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences
Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology
Disclosure: Nothing to disclose.

 
 
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