Clinical suspicion of eyelid lesion malignancy should prompt biopsy
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KOLOA, Hawaii — Distinguishing between benign and malignant lesions is key when managing eyelid lesions, a speaker said at Hawaiian Eye 2023.
“I do not send every lesion for pathology ... but if things look a little abnormal, I think it is reasonable to send,” Andrew Harrison, MD, said.
If the clinical suspicion of malignancy and the pathology results do not agree, he considers repeating the biopsy.
Features that may prompt suspicion that a lesion is malignant are growth over time, in that malignancies often grow more rapidly than lesions that are stable, ulceration of the lesion, which may indicate that the lesion is outgrowing its blood supply, destruction of the eyelid margin architecture, including loss of eyelashes, and irregular pigmentation.
Surgeons should make photo documentation a key part of their lid lesion treatment process, which shows precisely where any biopsy was performed and helps surgeons follow the growth of lesions, he said.
“In summary, recognize the features of malignancy, biopsy almost all lesions that fail to improve, know someone who deals with and is comfortable with lid lesions, and just do it,” Harrison said.
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Harrison A. Just do it! (Biopsy lid lesions). Presented at: Hawaiian Eye 2023; Jan. 14-20, 2023; Koloa, Hawaii.
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