Invasive squamous cell carcinoma of the eyelids and periorbital region

Aim: To review the clinical and histopathological features, treatment and outcomes of squamous cell carcinoma of the eyelids. Methods: 76 patients with eyelid squamous cell carcinoma treated in an oncology referral hospital between 1997 and 2006 were reviewed retrospectively. Age, sex, risk factors, duration of symptoms, size and location of lesion, previous recurrences, presence of perineural invasion (PNI) and orbital invasion, histological subtype, inflammatory response of peritumoral tissue were recorded and analysed. Results: Mean (SD) lesion size was 2.4 (0.36) mm. 27 (35.5%) cases were previously recurrent. The most common histological subtype was well differentiated (59.2%). The rates of PNI and orbital invasion were 23.8% and 43.4%, respectively. 63 patients underwent surgery, whereas others were treated with external radiotherapy or chemotherapy. Recurrence or presence of residual tumour rate was 22.4%, most of them had orbital invasion. Regional lymph node metastasis was detected in 5 (6.6%) cases. Conclusions: Advanced deep local invasion was not rare in this study, as a result of treatment delay and previous inadequate treatments. Adverse prognostic factors associated with secondary orbital invasion are previous recurrences, longer duration of lesion, larger lesion size, and presence of PNI. Well-differentiated subtype and strong inflammatory response are good prognostic factors.