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Eyelid and Periocular Cutaneous Carcinomas

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Albert and Jakobiec's Principles and Practice of Ophthalmology

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Abstract

Cutaneous malignancies frequently manifest in the periocular region and are most commonly associated with ultraviolet radiation. Basal cell carcinoma is the most prevalent, comprising 85–95% of all eyelid malignancies. Cutaneous squamous cell carcinoma is second most common, representing 3.4–12.6% of eyelid malignancies. Sebaceous carcinoma and melanoma represent less than 1% of eyelid carcinomas. Rarer presentations of periorbital cutaneous malignancies include Merkel cell carcinoma, microcystic adnexal carcinoma, angiosarcoma, various lymphomas, and undifferentiated pleomorphic sarcoma. Timely diagnosis and treatment of periorbital cutaneous malignancies is imperative due to their propensity to invade local structures and their potential spread along branches of the trigeminal, facial, or oculomotor nerves, sometimes into the brain. The standard of care for localized eyelid carcinomas is surgical excision with negative margin confirmation. High-risk keratinocyte carcinomas are most commonly treated with Mohs micrographic surgery (MMS), which facilitates margin control with minimal collateral damage to normal tissue. This is especially useful in the aesthetically and functionally sensitive region of the eyelid. Other therapies include standard elliptical excision, cryotherapy, curettage and electrodesiccation (C&E), topical therapies, radiation, chemotherapy (both broad and targeted), and immunotherapy. This chapter reviews the diagnosis and treatment of periocular cutaneous malignancies.

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Author information

Authors and Affiliations

  1. Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA

    Taylor R. Erickson

  2. University of Michigan Medical School, Ann Arbor, MI, USA

    Curtis J. Heisel & Christopher K. Bichakjian

  3. Department of Dermatology, University of Michigan, Ann Arbor, MI, USA

    Christopher K. Bichakjian

  4. Consultants in Ophthalmic and Facial Plastic Surgery, Southfield, MI, USA

    Alon Kahana

  5. Ophthalmology Department, Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA

    Alon Kahana

Authors
  1. Taylor R. Erickson
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  2. Curtis J. Heisel
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  3. Christopher K. Bichakjian
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  4. Alon Kahana
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Corresponding author

Correspondence to Alon Kahana .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology, Oregon Health & Science University Department of Ophthalmology, Portland, OR, USA

    Daniel Albert

  2. Massachusetts Eye and Ear, Boston, MA, USA

    Joan Miller

  3. Department of Ophthalmology, University of Illinois at Chicago Department of Ophthalmology, Chicago, IL, USA

    Dimitri Azar

  4. Department of Ophthalmology, Harvard Medical School, Boston, MA, USA

    Lucy H. Young

Section Editor information

  1. School of Medicine, Oregon Health & Science University, Portland, OR, USA

    Eric Steele

  2. School of Medicine, Oregon Health & Science University, Portland, USA

    John Ng

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Erickson, T.R., Heisel, C.J., Bichakjian, C.K., Kahana, A. (2020). Eyelid and Periocular Cutaneous Carcinomas. In: Albert, D., Miller, J., Azar, D., Young, L.H. (eds) Albert and Jakobiec's Principles and Practice of Ophthalmology. Springer, Cham. https://doi.org/10.1007/978-3-319-90495-5_77-1

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