Epidemiology of eyelid tumors and tumor-like lesions: a retrospective study of neoplastic and non-neoplastic lesions in a tertiary medical center
This retrospective study of 929 eyelid lesions at a tertiary medical center over 11 years reveals that neoplastic lesions constitute 73.3% of cases (with benign tumors being most common and basal cell carcinoma the leading malignancy), while non-neoplastic tumor-like lesions account for the remaining 26.7%.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Every day, people visit eye doctors with small lumps or bumps on their eyelids. These growths are common, but they are not all the same. Some are harmless collections of cells that have grown a little too much, while others are true cancers that can spread if left untreated. There is also a third group: things that look like tumors but are actually just cysts or overgrowths of normal skin tissue. Because these different conditions can look very similar to the naked eye, doctors often need to remove the growth and examine it under a microscope to know exactly what they are dealing with. Understanding which types of lumps are most common, and who is most likely to have them, helps doctors make better guesses before they even cut. It guides them on how urgently to act and what to tell their patients about the risks.
A team of researchers at a major hospital in southern Taiwan decided to take a fresh look at this problem. They gathered information on nearly a thousand patients who had eyelid growths removed between 2013 and 2024. By reviewing the medical records and the final pathology reports for every single case, they created a clear picture of what these eyelid masses actually are in their local population. Their work covers a wide range of conditions, from simple benign growths to aggressive cancers, and includes the "tumor-like" lesions that mimic real tumors.
The study found that the vast majority of these eyelid masses are not cancer. Out of all the growths that were confirmed to be tumors, about three-quarters were benign, meaning they are not life-threatening. The most common of these harmless tumors were moles, specifically a type called intradermal nevi, followed by warts and small skin tags. The other quarter of the tumor cases were malignant, or cancerous. Among these cancers, the most frequent type was basal cell carcinoma, a slow-growing skin cancer that rarely spreads but can damage local tissue if ignored. The second most common cancer was a more serious type called sebaceous gland carcinoma, which arises from the oil glands of the eyelid. The third most common was squamous cell carcinoma.
Age played a major role in who developed these conditions. The researchers observed that people with benign tumors were generally younger, often in their forties or fifties. In contrast, the patients with malignant tumors were significantly older, with an average age of about seventy years. The likelihood of finding a cancer increased steadily as patients got older, with the highest number of cases appearing in people between their mid-seventies and late eighties. The study also noted a difference between men and women. While most benign tumors appeared slightly more often in women, the pattern for cancers varied by type. Basal cell carcinoma was slightly more common in women, whereas squamous cell carcinoma appeared more often in men. Interestingly, the oil gland cancer, sebaceous carcinoma, was found much more frequently in women than in men.
Not every lump on an eyelid is a tumor at all. The researchers discovered that about one-quarter of all the masses they examined were non-neoplastic, meaning they were not true tumors. These were mostly cysts, which are small sacs filled with fluid or skin debris, or areas where the skin had simply thickened or grown extra layers. These conditions can look exactly like a tumor to a doctor, which is why removing them for examination is so important. Without a microscopic look, it is easy to mistake a harmless cyst for a cancer, or vice versa.
The researchers also compared their findings with studies from other parts of the world. They confirmed that, like in many other places, benign tumors are far more common than malignant ones. However, they noticed something specific about their region: the rate of sebaceous gland carcinoma was higher than what is typically seen in Western countries. While this cancer is rare in places like Europe or the United States, it made up nearly a quarter of all cancers in this Taiwanese study. This difference might be due to genetic factors or environmental exposures, such as the amount of sunlight people receive, though the exact reason remains unclear.
This study serves as a practical guide for eye doctors in the region. It confirms that while most eyelid lumps are harmless, the risk of cancer rises sharply with age, particularly after seventy. It also highlights that a significant number of eyelid masses are not tumors at all, but rather cysts or skin overgrowths that can be easily confused with cancer. By knowing the specific mix of conditions they are likely to see, doctors can better prepare their patients for surgery and ensure that every suspicious growth is checked properly. The work underscores that while most eyelid lumps are not dangerous, careful examination is essential to catch the few that are, especially in older patients.
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