The treatment of tumors of the eyelid is both complex, and fascinating. The choice of treatment depends upon, the type of tumor (benign, malignant, specific diagnosis),, size, location (upper or lower eyelid, canthus involvement,, deeper involvement to ocular surface or orbit), the, age and systemic health of the patient, and the surgeon’s, preference (see Chapter 2).1, For appropriate management, the basic oncological principles, must be followed:, • Adequate tissue biopsy for diagnosis., • Assessment of tumor margins., • Evaluation for local and systemic spread., In Chapter 36 we discuss the clinical features of common, eyelid tumors. Herein we discuss the management,, including surgery, radiation, cryotherapy, PDT, and, chemotherapy (Mind Map 37-1). We also provide a broad, overview of reconstructive techniques following excision, and the prognosis of common eyelid malignancies.
Chapter Keyword: biopsy
Orbital Neoplasms: Past, Present, and Future
This chapter contains an overview of the evolution of, diagnosis and treatments for orbital tumours.1-4 This leads, to a chapter that contains a rational format summarizing, the pertinent themes of diagnosis and treatment utilizing, present-day information. Lastly, I probe and forecast, our likely future.
Prognostication in Uveal Melanoma
Uveal melanoma (UM) has a propensity for metastasis which results in high mortality.1,2 As metastases are rarely detectable at the time of diagnosis, great efforts have been directed toward accurate prognostication and identifying high-risk factors for metastasis.3-5 One can differentiate between clinical, histopathologic, and genetic prognostic factors.6 However, this chapter reveals the breadth of parameters that must be taken into account when trying to predict a patient’s prognosis.7 These include, but are not limited to, the age of the patient, tumor-specific factors, patient comorbidities, the effectiveness of local treatment, and a plethora of tumor-associated mutations and aberrations, all of which influence the risk for metastatic disease.6,8,9
Melanocytoma of the Uvea and Optic Nerve
Melanocytomas (magnocellular nevi) are deeply pigmented, melanocytic nevi. They can occur in the eye,, central nervous system (CNS), and rarely in the skin., Melanocytomas of the CNS occur in the meninges and, spinal cord, and may be rarely associated with intraocular, melanocytomas.1 Ocular melanocytomas have been, reported to arise in the iris, ciliary body, choroid, optic, disc, sclera, and orbit.1-4, Rarely symptomatic, isolated cases of painful melanocytoma, involving the ciliary body and iris root are likely, associated with secondary pigment-dispersion glaucoma.5,6, Local growth and large lesions cause symptoms and vision, loss. Though there are no reported cases of systemic metastasis,, malignant transformation has been documented.7, Enucleated eye specimens have shown malignant transformation, of the magnocellular nevus with mitoses,, neovascularization, and exudative retinal detachment.