EYELID

WORKUP

  • may appear superficial but actually penetrate deeply into the globe.
  • CT is essential for accurate determination of tumor extent.

PRIMARY TREATMENT

1-5 mm

  • surgical excision is preferred
  • RT may be used

> 5 mm lesion

  • radiation has been very successful for both BCC and SCCA.
    • large carcinomas of the eyelids and canthi where good surgical margins cannot be obtained.
    • after surgical recurrence

Orbital invasion

  • enucleation
  • radiation
  • note: RT alone may cure some of these advanced lesions

POSTOPERATIVE RADIATION

ELECTIVE NODAL TREATMENT

FIRST ECHELON NODES

Indications

  • recurrent lesions
  • perineural invasion

FIELD for MEDIAL LESIONS (my guess)

  • Local Field and
  • Mustache Field (Fu Manchu)
  • and Upper Neck Field

== SEE NOSE FOR FIELD PICTURE ==

FIELD for LATERAL and UPPER LESIONS (my guess)

  • Local Field and
  • Parotid
  • and Upper Neck Field

== SEE PAROTID FOR FIELD PICTURE ==

SECOND ECHELON

RADIATION TREATMENT

eye
  • an internal eye shield may be used to protect the globe.
  • If possible, when treating upper eyelid tumors the lacrimal gland should be shielded to avoid late keratoconjunctivitis due to dry eye. However, shielding should be withheld rather than blocking tumor becasue complications often can be treated with minor surgical procedure.
Unless otherwise stated, the content of this page is licensed under Creative Commons Attribution-Share Alike 2.5 License.