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Eyelid and conjunctiva: neoplasia
Introduction
- Cause: usually spontaneous, exposure to high levels of UV radiation.
- Signs: mass, ocular discharge, 'red eye', ocular discomfort, periocular swelling.
- Diagnosis: clinical examination, cytology, histopathology.
- Treatment: surgical excision, radiotherapy, chemotherapy, plesiotherapy.
- Prognosis: guarded, often malignant.
Presenting signs
- Presence of an eyelid mass.
- Eyelid ulceration and hemorrhage.
- Periocular swelling.
- Ocular discharge.
- Discomfort.
- 'Red eye'.
Acute presentation
- Periocular swelling.
- Ocular discomfort.
Geographic incidence
- Squamous cell carcinoma Squamous cell carcinoma: higher incidence in areas with high UV levels.
Age predisposition
- Usually a disease of older cats.
Breed/Species predisposition
- None for most neoplasms.
- Apocrine hidrocystoma most common in the Persian Persian longhair.
Cost considerations
- Surgical excision and ancillary therapies can be expensive.
Pathogenesis
Etiology
- In order of decreasing frequency:
- Squamous cell carcinoma Squamous cell carcinoma (most common by far)
. - Apocrine hidrocystoma
. - Mast cell tumor Mastocytoma
. - Melanoma Melanoma
- Basal cell carcinoma Basal cell tumor.
- Hemangiosarcoma Hemangiosarcoma
. - Adenocarcinoma Adenoma / adenocarcinoma.
- Fibrosarcoma Fibrosarcoma
. - Peripheral nerve sheath tumor Nerve sheath: neoplasia.
- Lymphoma Lymphoma
.
- Squamous cell carcinoma Squamous cell carcinoma (most common by far)
Predisposing factors
General
- Older cats.
- Unpigmented eyelids.
- Sunny climates.
Specific
- High levels of UVB can induce malignant transformation of squamous epithelial cells.
Pathophysiology
- High levels of UVB can induce malignant transformation of squamous epithelial cells.
Timecourse
- Weeks to months.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Murphy S (2013) Cutaneous squamous cell carcinoma in the cat: current understanding and treatment approaches. J Feline Med Surg 15 (5), 401-407 PubMed.
- Montgomery K W, van der Woerdt A, Aquino S M et al (2010) Periocular cutaneous mast cell tumors in cats: evaluation of surgical excision (33 cases). Vet Ophthalmol 13 (1), 26-30 PubMed.
- Schobert C S, Labelle P, Dubielzig R R (2010) Feline conjunctival melanoma: histopathological characteristics and clinical outcomes. Vet Ophthalmol 13 (1), 43-46 PubMed.
- Newkirk K M, Rohrbach B W (2009) A retrospective study of eyelid tumors from 43 cats. Vet Pathol 46 (5), 916-927 PubMed.
- Aquino S M (2007) Management of eyelid neoplasms in the dog and cat. Clinical techniques in Small Animal Practice 22 (2), 46-54 PubMed.
Other sources of information
- Mitchell N & Oliver J (2015) Feline Ophthalmology - The Manual. Servet. ISBN 978-84-16315-11-6.
- Gould D & McLellan G (2014) BSAVA Manual of Small Animal Ophthalmology. 3rd edn. British Small Animal Veterinary Association.