This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Skin Cancer  • Oncology, Other  • External Eye Disease  • Ocular/ Adnexal Tumors  • Dermatology  • Melanoma  • Alert me on articles by topic  Social Bookmarking   What's this?

Report of 20 Cases and Review of the Literature

Carlos Bianciotto, MD; Hakan Demirci, MD; Carol L. Shields, MD; Ralph C. Eagle Jr, MD; Jerry A. Shields, MD

Arch Ophthalmol. 2009;127(8):999-1005.

Objective  To determine the primary sites, clinical features, treatment, and outcome of 20 patients with cancer metastatic to the eyelids.

Methods  Retrospective review of medical records.

Results  The primary tumors included skin melanoma (4 [20%]), uveal melanoma (4 [20%]), breast carcinoma and conjunctival melanoma (3 [15%] each), renal cell carcinoma (2 [10%]), and medullary thyroid carcinoma, prostate carcinoma, lung carcinoma, and salivary gland carcinoma (1 [5%] each). Eyelid metastasis was the first sign of systemic cancer in 3 patients (15%). The most common clinical finding at the initial examination was a solitary nodule in 12 patients (60%), a flat pigmented lesion and diffuse eyelid swelling in 3 patients each (15%), and multiple nodules and epiphora in 1 patient (5%) each. Ten patients (50%) had concomitant ocular site metastasis. Primary treatment included excision alone in 6 patients (30%), external beam radiotherapy in 7 (35%), systemic chemotherapy in 4 (20%), and observation in 3 (15%). The metastatic tumors regressed in 10 patients (50%), remained stable in 7 (35%), and showed progression in 3 (15%). After a mean follow-up of 16 months, 9 patients (45%) were alive and 11 (55%) had died of systemic metastatic disease.

Conclusions  Eyelid metastasis can display a variety of clinical features and should be considered in patients with known systemic cancer. These patients usually have multiple metastatic sites, ocular and nonocular. The systemic prognosis is poor.

Author Affiliations: Ocular Oncology Service (Drs Bianciotto, Demirci, C. L. Shields, and J. A. Shields) and Department of Pathology (Dr Eagle), Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?