Eye cancer | Recognizing symptoms & finding specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

Tumors canalso form in the eye - both benign and malignant. The eye is a highly complex organ consisting of very different layers of tissue. There is therefore a wide variety of eye tumors.

While benign changes are hardly a problem, malignant eye tumors must be detected and treated in good time. Otherwise, not only the function of the visual organ but also the life of the person affected is at risk.

You can find all the information and selected specialists for the treatment of eye cancer here.

ICD codes for this diseases: C69

Recommended specialists

Brief overview:

  • What is eye cancer? A benign or malignant tumor that forms in the layers of tissue in or around the eye.
  • Basal cell carcinoma of the eyelid (eyelid tumor): Benign tumor that can be easily treated with surgery. The prognosis is therefore good overall.
  • Carcinoma of the conjunctiva: Frequently caused by sun exposure, often remains asymptomatic for a long time. Treated by surgical removal, possibly also radiation and treatment with a cytostatic drug.
  • Retinoblastoma: The most common eye tumor in children. The eye can often be preserved, but vision is often severely impaired afterwards. The prognosis has improved significantly in recent years, 97% of all children with this tumor are still alive after five years.
  • Melanoma of the choroid, iris and conjunctiva: "Black skin cancer" that affects layers of tissue in the eye. It is a very dangerous tumor that also metastasizes. The earlier the tumor is treated with radiotherapy or surgery, the better the prognosis.

Article overview

Where can eye tumors develop?

The most important anatomical areas of the eye where malignant eye tumors can develop are

  • the eyelids,
  • the surface of the eye, e.g. the conjunctiva,
  • the retina and
  • the choroid.

Below we present the most dangerous cancers of the eye (eye tumors):

  • Basal cell carcinoma of the eyelid (eyelid tumor)
  • Carcinoma of the conjunctiva
  • Retinoblastoma
  • Melanoma of the choroid, iris and conjunctiva

Basal cell carcinoma of the eyelid (eyelid tumor)

Most tumors on the eyelid are benign. This was recently confirmed by an analysis of more than 5,000 eyelid tumors by the University Eye Clinic in Lausanne. However, the detection of malignant growths is all the more important. Malignant tumors are easy to treat if they are not yet too large.

In one respect, basal cell carcinoma is completely atypical of a malignant tumor: it very rarely metastasizes. However, if it is not detected or treated in time, it can eat through its immediate surroundings - even through bone. This may require extensive plastic surgery.

Frequency of eyelid tumors

At around 90 percent, basal cell carcinoma is by far the most common malignant eyelid tumor. It is becoming increasingly common: numerous epidemiological studies indicate a rapid increase in the number of cases in some countries. Exposure to sunlight is considered an important risk factor.

Sonnenschein

Sunlight is considered a major risk factor for the development of basal cell carcinoma.

This eye tumor looks like a raised lump. It often has a crater-shaped, sometimes bleeding and crusted depression in its center. Basal cell carcinoma occurs in more than 40 percent of cases on the lower eyelid. In 12 percent of cases, it occurs on the upper eyelid and otherwise in the inner and outer corner of the eyelid.

Basal cell carcinoma - incidentally the most common malignant skin tumor of all - mainly affects older people over the age of 60. Individuals with fair skin are particularly at risk.

Treatment of eyelid tumors

The most common form of treatment for this type of eye tumor is surgical excision. In microscopically controlled surgery (Mohs surgery), the specialist examines tissue samples for histology. In the case of very rare complex initial findings, this is done while the patient is still on the operating table. If the edges of the incisions are not free of tumor cells, the procedure is extended until the edges of the incisions are tumor-free.

In a collective of 385 basal cell carcinoma patients, 92 percent were spared a recurrence after more than 12 years of follow-up. In rare cases, basal cell carcinoma is also treated with cryotherapy, i.e. a local application of cold. This treatment can be used, for example, in older patients for whom extensive surgery appears too dangerous. The prognosis for this eye tumor is generally good.

Carcinoma of the conjunctiva

Exposure to sunlight is also an important risk factor for conjunctival carcinoma. This can begin undramatically as a whitish elevation on the conjunctiva, to which quite conspicuous blood vessels may run. The dangerous thing about conjunctival carcinoma is that it does not present a typical picture and does not look very dramatic in the early stages. It also causes hardly any subjective symptoms. The treatment of this type of eye tumor consists of surgical removal. Dependingon the extent of the tumor, it may need to be treated with radiotherapy or locally with the cytostatic drug mitomycin C.

Retinoblastoma

Retinoblastoma, which develops from abnormally altered, immature retinal cells, is the most common eye tumor in children.

Retinoblastom

It occurs approximately once in every 10,000 to 20,000 births and practically always manifests itself before the age of 3. In a good third of children, this eye tumor occurs bilaterally: both eyes are affected by the tumor. The cause is a genetic predisposition or a mutation during embryonic development of the retina. If there are cases of retinoblastoma in a family, couples who wish to have children should seek genetic counseling. After birth, an ophthalmologist should examine the baby at an early stage.

Retinoblastoma.jpg
From http://visualsonline.cancer.gov/details.cfm?imageid=2418, Public domain, Link

Symptoms of retinoblastoma

As the child is too small to show any symptoms, it is often only noticed by the parents: the pupillary reflex when the eye is illuminated (for example in a photo with a flash) is not red, but white. The retinoblastoma is light in color. It usually grows into the inside of the eye, into the vitreous body, after the tumor has detached the retina.

Growth out of the eye, into the optic nerve and thus towards the brain, is also possible. Another indication of a retinoblastoma can be a squint. In this case, it is a deviation of the affected and practically sightless eye.

Retinoblastom Symptome

Treatment of retinoblastoma

Until recently, enucleation, the removal of the eyeball, was the standard treatment for retinoblastoma. Advances in chemotherapy and radiotherapy enable survival and preservation of the eye in most cases. Even if the eye is usually severely visually impaired or blind.

If the eye tumor is not too large, a radiation carrier can be sutured onto the sclera from the outside over the tumor. This "plaque" remains there for several months, destroys the tumor cells and causes the retinoblastoma to shrink. In specialized centers, radiation with protons (from the outside) can also be used.

Chemotherapeutic agents can be administered to the eye tumor via the artery leading into the eye ("chemosurgery"). After successful therapy, the children must be examined regularly over the next few years. In this way, a possible recurrence can be detected in good time.

Overall, the prognosis for this type of eye tumor is much better today than it was just a few years ago: a study from Singapore published at the end of 2012 showed a 5-year survival rate of 97% for unilateral retinoblastoma.

Melanomas of the choroid, iris and conjunctiva

Melanomas originate from pigment-containing cells, the melanocytes. They occur in different layers of the eye. Melanoma of the choroid, the layer of blood vessels under the retina, is the most common malignant tumor of the inside of the eye. It occurs about once in every 2,500 people.

Symptoms, diagnosis and treatment of choroidal melanoma

Unfortunately, it hardly causes any subjective symptoms. The affected person only notices something when the eye tumor is already quite large and impairs vision. During an ophthalmoscopy, an examination of the back of the eye with a dilated pupil, the ophthalmologist sees a deep dark protrusion. This detaches the retina and grows into the vitreous body.

Choroidal melanoma is a deadly threat: between 30 and 50 percent of those affected die from liver or lung metastases. It can be differentiated from harmless findings of the fundus with pigmentation by means of an ultrasound examination and fluorescein angiography.

Similar to retinoblastoma, radiotherapy can often prevent the removal of the eyeball. Surgical removal (resection) is also often possible with this type of eye tumor.

Symptoms, diagnosis and treatment of melanoma of the iris

If the melanoma occurs in the iris, it is usually recognized well and in good time. Even with this localization, the affected person notices little subjectively. A glance in the mirror can lead to the discovery of the finding. The eye surgeon can usually easily resect this eye tumor.

Symptoms, diagnosis and treatment of conjunctival melanoma

The conjunctiva is the layer of the eye on which melanomas are actually easy to recognize and identify: as dark lumps against the background of the white sclera. However, it is not easy to distinguish melanoma from other forms of pigment deposits in this transparent layer.

In melanosis of the conjunctiva, melanin-containing cells color large parts of the conjunctiva dark brown. In Caucasians, this is considered a potential precursor of melanoma. In Africans, on the other hand, melanosis is harmless.

Early removal is also the treatment of choice in the case of conjunctival melanoma. Unfortunately , conjunctival melanomas metastasize early , usually first to the lymph nodes in the head and neck area.

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