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 p atients with malignant eyelid tumors in an incidence cohort. Design: Cohort series. Participants: A computerized retrieval system was used to identify all pati ents residing in Olmsted County, Minnesota, who had a newly diagnosed malig nant eyelid tumor during the 15-year interval from 1976 through 1990. The p atients' medical records were reviewed for demographic and clinical data. Intervention: Surgical excision with frozen-section histopathologic analysi s, Mohs' micrographic excision, and electrodesiccation and curettage were t he primary methods of treatment. Main Outcome Measures: Survivorship free of tumor. Results: The incidence cohort included 174 patients who each had 1 tumor; m en and women were equally affected, and all patients were white. Tumors dev eloped 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 e qual 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 melan oma. 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 glan d carcinoma were identified. The 5- and 10-year recurrence rates for all tu mors on the eyelid were 2% and 3%, respectively. The probability of an unre lated malignancy developing elsewhere in the body was approximately 9% at 5 years and 15% at In 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 e xcision is uncommon.