Epidemiologic characteristics and clinical course of patients with malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota.

OBJECTIVE: To determine the epidemiologic and clinical characteristics of patients with malignant eyelid tumors in an incidence cohort.

DESIGN: Cohort series.

PARTICIPANTS: A computerized retrieval system was used to identify all patients residing in Olmsted County, Minnesota, who had a newly diagnosed malignant eyelid tumor during the 15-year interval from 1976 through 1990. The patients' medical records were reviewed for demographic and clinical data.

INTERVENTION: Surgical excision with frozen-section histopathologic analysis, Mohs' micrographic excision, and electrodesiccation and curettage were the primary methods of treatment.

MAIN OUTCOME MEASURES: Survivorship free of tumor.

RESULTS: The incidence cohort included 174 patients who each had 1 tumor; men and women were equally affected, and all patients were white. Tumors developed most commonly on the lower eyelid (n = 85; 48.9%) and in the medial canthal region (n = 48; 27.6%) but involved the right and left sides with equal frequency. Of the 174 tumors, 158 were basal cell carcinomas (90.8%), 15 were squamous cell carcinomas (8.6%), and 1 (0.6%) was a malignant melanoma. The age- and gender-adjusted incidence rates for basal cell carcinoma, squamous cell carcinoma, and malignant melanoma were 14.35, 1.37, and 0.08 per 100,000 individuals per year, respectively. No cases of sebaceous gland carcinoma were identified. The 5- and 10-year recurrence rates for all tumors on the eyelid were 2% and 3%, respectively. The probability of an unrelated malignancy developing elsewhere in the body was approximately 9% at 5 years and 15% at 10 years.

CONCLUSIONS: Basal cell carcinoma is the most common malignant eyelid tumor in whites. The lower eyelid and medial canthus are the most frequent sites of origin. Men and women are equally affected. Recurrence after surgical excision is uncommon.