Skip to main content
SpringerLink
Log in

Benign Squamous and Melanocytic Tumors

  • Chapter
  • First Online:
Clinical Ophthalmic Oncology

Abstract

Benign tumors of the eyelid include a variety of nonpigmented and pigmented epidermal tumors (arising from squamous or melanocytic cells), adnexal tumors (Chap. 4), and stromal tumors (Chap. 5). Important to note is that not all clinically pigmented lesions are melanocytic, since squamous cells can pick up melanin pigment, thus giving a pigmented appearance to a lesion. The benign epidermal tumors of the eyelid are similar to those observed in the other sun-exposed areas of the skin, but they may also include conjunctival tumors as well. Some of these tumors represent manifestations of systemic disease (Chap. 12). A classification of the epidermal eyelid tumors is presented in Table 3.1. Only the description of the most common and frequently observed benign tumors, along with their corresponding premalignant lesions and tumorlike nonneoplastic lesions are included in this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Font RL. Eyelids and lacrimal drainage system. In: Spencer WH, editor. Ophthalmic pathology. An atlas and textbook. 4th ed. Philadelphia: WB Saunders; 1996. p. 2229–32.

    Google Scholar 

  2. Rosai J. Rosai and Ackerman’s surgical pathology. 10th ed. New York: Mosby Elsevier; 2011. p. 129–213.

    Google Scholar 

  3. Boniuk M, Zimmerman LE. Eyelid tumors with reference to lesions confused with squamous cell carcinoma. II. Inverted follicular keratosis. Arch Ophthalmol. 1963;69:698–707.

    Article  PubMed  CAS  Google Scholar 

  4. Brinster NK, Liu V, Diwan AH, McKee PH. High yield pathology: dermatopathology. Philadelphia: Saunders Elsevier; 2011. p. 365–80.

    Google Scholar 

  5. Grossniklaus HE, Wojno TH, Yanoff M, Font RL. Invasive keratoacanthoma of the eyelid and ocular adnexa. Ophthalmology. 1996;103:937–41.

    Article  PubMed  CAS  Google Scholar 

  6. Leibovitch I, Huilgol SC, James CL, Hsuan JD, Davis G, Selva D. Periocular keratoacanthoma: can we always rely on the clinical diagnosis? Br J Ophthalmol. 2005;89:1201–4.

    Article  PubMed  CAS  Google Scholar 

  7. Donaldson MJ, Sullivan TJ, Whitehead KJ, Williamson RM. Periocular keratoacanthoma: clinical features, pathology, and management. Ophthalmology. 2003;110:1403–7.

    Article  PubMed  Google Scholar 

  8. Mencia-Gutierrez E, Gutierrez-Diaz E, Redondo-Marcos I, Ricoy JR, Garcia-Torre JP. Cutaneous horns of the eyelid: a clinicopathological study of 48 cases. J Cutan Pathol. 2004;31:539–43.

    Article  PubMed  Google Scholar 

  9. Vujevich JJ, Mancini AJ. The epidermal nevus syndromes: multisystem disorders. J Am Acad Dermatol. 2004;50:957–61.

    Article  PubMed  Google Scholar 

  10. Miller CJ, Ioffreda MD, Billingsley EM. Sebaceous carcinoma, basal cell carcinoma, trichoadenoma, trichoblastoma, and syringocystadenoma papilliferum arising within a nevus sebaceus. Dermatol Surg. 2004;30:1546–9.

    Article  PubMed  Google Scholar 

  11. Fu W, Cockerell CJ. The actinic (solar) keratosis: a 21st-century perspective. Arch Dermatol. 2003;139:66–70.

    Article  PubMed  Google Scholar 

  12. Lebwohl M. Actinic keratosis: epidemiology and progression to squamous cell carcinoma. Br J Dermatol. 2003;149 Suppl 66:31–3.

    Article  PubMed  Google Scholar 

  13. Mittelbronn MA, Mullins DL, Ramos-Caro FA, Flowers FP. Frequency of pre-existing actinic keratosis in cutaneous squamous cell carcinoma. Int J Dermatol. 1998;37:677–81.

    Article  PubMed  CAS  Google Scholar 

  14. Marks R, Rennie G, Selwood TS. Malignant transformation of solar keratoses to squamous cell carcinoma. Lancet. 1988;1:795–7.

    Article  PubMed  CAS  Google Scholar 

  15. Person JR. An actinic keratosis is neither malignant nor premalignant: it is an initiated tumor. J Am Acad Dermatol. 2003;48:637–8.

    Article  PubMed  Google Scholar 

  16. Anwar J, Wrone DA, Kimyai-Asadi A, Alam M. The development of actinic keratosis into invasive squamous cell carcinoma: evidence and evolving classification schemes. Clin Dermatol. 2004;22:189–96.

    Article  PubMed  Google Scholar 

  17. Lober BA, Fenske NA. Optimum treatment strategies for actinic keratosis (intraepidermal squamous cell carcinoma). Am J Clin Dermatol. 2004;5:395–401.

    Article  PubMed  Google Scholar 

  18. Pirard D, Vereecken P, Melot C, Heenen M. Three percent diclofenac in 2.5% hyaluronan gel in the treatment of actinic keratoses: a meta-analysis of the recent studies. Arch Dermatol Res. 2005;297:185–9.

    Article  PubMed  CAS  Google Scholar 

  19. Krengel S. Nevogenesis–new thoughts regarding a classical problem. Am J Dermatopathol. 2005;27:456–65.

    Article  PubMed  Google Scholar 

  20. Tannous ZS, Mihm Jr MC, Sober AJ, Duncan LM. Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management. J Am Acad Dermatol. 2005;52:197–203.

    Article  PubMed  Google Scholar 

  21. Kopf AW, Bart RS, Hennessey P. Congenital nevocytic nevi and malignant melanomas. J Am Acad Dermatol. 1979;1:123–30.

    Article  PubMed  CAS  Google Scholar 

  22. Watt AJ, Kotsis SV, Chung KC. Risk of melanoma arising in large congenital melanocytic nevi: a systematic review. Plast Reconstr Surg. 2004;113:1968–74.

    Article  PubMed  Google Scholar 

  23. Krengel S, Hauschild A, Schafer T. Melanoma risk in congenital melanocytic naevi: a systematic review. Br J Dermatol. 2006;155:1–8.

    Article  PubMed  CAS  Google Scholar 

  24. Anonymous. Consensus conference: precursors to malignant melanoma. JAMA 1984;251:1864–6.

    Google Scholar 

  25. Mark GJ, Mihm MC, Liteplo MG, Reed RJ, Clark WH. Congenital melanocytic nevi of the small and garment type. Clinical, histologic, and ultrastructural studies. Hum Pathol. 1973;4:395–418.

    Article  PubMed  CAS  Google Scholar 

  26. Pollock PM, Harper UL, Hansen KS, Yudt LM, Stark M, Robbins CM, Moses TY, Hostetter G, Wagner U, Kakareka J, Salem G, Pohida T, Heenan P, Duray P, Kallioniemi O, Hayward NK, Trent JM, Meltzer PS. High frequency of BRAF mutations in nevi. Nat Genet. 2003;33:19–20.

    Article  PubMed  CAS  Google Scholar 

  27. Margo CE, Rabinowicz IM, Habal MB. Periocular congenital melanocytic nevi. J Pediatr Ophthalmol Strabismus. 1986;23:222–6.

    PubMed  CAS  Google Scholar 

  28. Makkar HS, Frieden IJ. Neurocutaneous melanosis. Semin Cutan Med Surg. 2004;23:138–44.

    Article  PubMed  Google Scholar 

  29. McDonnell PJ, Mayou BJ. Congenital divided naevus of the eyelids. Br J Ophthalmol. 1988;72:198–201.

    Article  PubMed  CAS  Google Scholar 

  30. Hamming N. Anatomy and embryology of the eyelids: a review with special reference to the development of divided nevi. Pediatr Dermatol. 1983;1:51–8.

    Article  PubMed  CAS  Google Scholar 

  31. Nawa Y, Hara Y, Saishin M. Conjunctival melanoma associated with extensive congenital conjunctival nevus and split nevus of eyelid. Arch Ophthalmol. 1999;117:269–71.

    PubMed  CAS  Google Scholar 

  32. Ribuffo D, Cavalieri L, Sonnino M, et al. Divided nevus of the eyelid: a case report. Ophthal Plast Reconstr Surg. 1996;12:186–9.

    Article  PubMed  CAS  Google Scholar 

  33. Folberg R, Jakobiec FA, Bernardino VB, Iwamoto T. Benign conjunctival melanocytic lesions. Clinicopathologic features. Ophthalmology. 1989;96:436–61.

    PubMed  CAS  Google Scholar 

  34. Mones JM, Ackerman AB. “Atypical” blue nevus, “malignant” blue nevus, and “metastasizing” blue nevus: a critique in historical perspective of three concepts flawed fatally. Am J Dermatopathol. 2004;26:407–30.

    Article  PubMed  Google Scholar 

  35. Demirci H, Shields CL, Shields JA, Eagle Jr RC. Malignant melanoma arising from unusual conjunctival blue nevus. Arch Ophthalmol. 2000;118:1581–4.

    Article  PubMed  CAS  Google Scholar 

  36. Gunduz K, Shields JA, Shields CL, Eagle Jr RC. Periorbital cellular blue nevus leading to orbitopalpebral and intracranial melanoma. Ophthalmology. 1998;105:2046–50.

    Article  PubMed  CAS  Google Scholar 

  37. Loffler KU, Witschel H. Primary malignant melanoma of the orbit arising in a cellular blue naevus. Br J Ophthalmol. 1989;73:388–93.

    Article  PubMed  CAS  Google Scholar 

  38. Odashiro AN, Arthurs B, Pereira PR, Filho JP, Belfort E, Burnier Jr MN. Primary orbital melanoma associated with a blue nevus. Ophthal Plast Reconstr Surg. 2005;21:247–8.

    Article  PubMed  Google Scholar 

  39. Van Raamsdonk CK, Bezrookove V, Green G, Bauer J, Gaugler L, O’Brien JM, Simpson EM, Barsh GS, Bastian BC. Frequent somatic mutations of GNAQ in uveal melanoma and blue nevi. Nature. 2009;457:599–602.

    Article  PubMed  Google Scholar 

  40. Singh AD, De Potter P, Fijal BA, Shields CL, Shields JA, Elston RC. Lifetime prevalence of uveal melanoma in white patients with oculo(dermal) melanocytosis. Ophthalmology. 1998;105:195–8.

    Article  PubMed  CAS  Google Scholar 

  41. Patel BC, Egan CA, Lucius RW, Gerwels JW, Mamalis N, Anderson RL. Cutaneous malignant melanoma and oculodermal melanocytosis (nevus of Ota): report of a case and review of the literature. J Am Acad Dermatol. 1998;38:862–5.

    Article  PubMed  CAS  Google Scholar 

  42. Wiecker TS, Luther H, Buettner P, Bauer J, Garbe C. Moderate sun exposure and nevus counts in parents are associated with development of melanocytic nevi in childhood: a risk factor study in 1,812 kindergarten children. Cancer. 2003;97:628–38.

    Article  PubMed  Google Scholar 

  43. MacLennan R, Kelly JW, Rivers JK, Harrison SL. The Eastern Australian Childhood Nevus Study: site differences in density and size of melanocytic nevi in relation to latitude and phenotype. J Am Acad Dermatol. 2003;48:367–75.

    Article  PubMed  Google Scholar 

  44. Winkelmann RK, Rocha G. The dermal nevus and statistics. An evaluation of 1,200 pigmented lesions. Arch Dermatol. 1962;86:310–5.

    Article  PubMed  CAS  Google Scholar 

  45. Spitz S. Melanoma of the childhood. Am J Pathol. 1948;24:591–609.

    PubMed  CAS  Google Scholar 

  46. Hiscott P, Seitz B, Naumann GO. Epithelioid cell Spitz nevus of the eyelid. Am J Ophthalmol. 1998;126:735–7.

    Article  PubMed  CAS  Google Scholar 

  47. Piepkorn M. The Spitz nevus is melanoma. Am J Dermatopathol. 2005;27:367–9.

    Article  PubMed  Google Scholar 

  48. Smith KJ, Skleton HG, Lupton GP, Graham JH. spindle cell and epithelioid cell nevi with atypia and metastasis (malignant Spitz nevus). Am J Surg Pathol. 1989;13:931–9.

    Article  PubMed  CAS  Google Scholar 

  49. Weedon D. Borderline melanocytic tumors. J Cutan Pathol. 1985;12:266–70.

    Article  PubMed  CAS  Google Scholar 

  50. Goldes J, Holmes S, Satz M, Cich J, Dehner L. Melanoma masquerading as Spitz nevus following acute lymphoblastic leukaemia. Pediatr Dermatol. 1984;1:295–8.

    Article  PubMed  CAS  Google Scholar 

  51. Marghoob AA. The dangers of atypical mole (dysplastic nevus) syndrome. Teaching at-risk patients to protect themselves from melanoma. Postgrad Med. 1999;105:147–8, 151–2, 154 passim.

    Article  PubMed  CAS  Google Scholar 

  52. Salopek TG. The dilemma of the dysplastic nevus. Dermatol Clin. 2002;20:617–28.

    Article  PubMed  Google Scholar 

  53. Clark Jr WH, Reimer RR, Greene M, Ainsworth AM, Mastrangelo MJ. Origin of familial malignant melanomas from heritable melanocytic lesions: ‘The B-K Mole syndrome’. Arch Dermatol. 1978;114:732–8.

    Article  PubMed  Google Scholar 

  54. NIH. NIH Consensus conference. Diagnosis and treatment of early melanoma. JAMA. 1992;268:1314–9.

    Article  Google Scholar 

  55. de Snoo FA, Bergman W, Gruis NA. Familial melanoma: a complex disorder leading to controversy on DNA testing. Fam Cancer. 2003;2:109–16.

    Article  PubMed  Google Scholar 

  56. Wetherington RW, Cockerell CJ. The “dysplastic” nevus: an update at 25 years. Adv Dermatol. 2003;19:237–48.

    PubMed  Google Scholar 

  57. Damato B, Singh D. Clinical Opthalmic Oncology: Uveal Tumors. Berlin: Springer (in press).

    Google Scholar 

  58. Stevenson O, Ahmed I. Lentigo maligna: prognosis and treatment options. Am J Clin Dermatol. 2005;6:151–64.

    Article  PubMed  Google Scholar 

  59. Hutchinson J. Notes on the cancerous process and on new growths in general. Arch Surg. 1890;2:83–6.

    Google Scholar 

  60. Klaus W, Allen JR, Dick S, Fitzpatrick TB. Fitzpatrick’s color atlas and synopsis of clinical dermatology. 5th ed. New York: The McGraw-Hill Companies; 2005.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pathology, Ohio State University Wexner Medical Center, 333 West 10th Avenue, Room 4162, Columbus, OH, 43210, USA

    Lynn Schoenfield MD

  2. Department of Ophthalmic Oncology, Cole Eye Institute and Taussig Cancer Center, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Arun D. Singh MD

Authors
  1. Lynn Schoenfield MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arun D. Singh MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lynn Schoenfield MD .

Editor information

Editors and Affiliations

  1. Department of Ophthalmology, Hadassah-Hebrew University, Jerusalem, Israel

    Jacob Pe'er

  2. Dept. of Ophthalmic Oncology, Cole Eye Institute Cleveland Clinic Foundation, Cleveland, Ohio, USA

    Arun D. Singh

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Schoenfield, L., Singh, A.D. (2014). Benign Squamous and Melanocytic Tumors. In: Pe'er, J., Singh, A. (eds) Clinical Ophthalmic Oncology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38336-6_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38336-6_3

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38335-9

  • Online ISBN: 978-3-642-38336-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation