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Benign lumps and bumps

The eyelids and related areas are specialised sites and there are numerous structures within the tissues that can give rise to lumps and bumps. The majority of lesions will be benign but there are several pre-cancerous or cancerous conditions which can affect this region. Often an experienced oculoplastic surgeon can make a clinical diagnosis based on the history and examination under a microscope. Occasionally, however, it can be difficult to decide if the lesion represents a benign or malignant problem and a biopsy is required. This involves removing a small sample of the lesion under local anaesthetic and sending it for tissue analysis. Further treatment may be recommended depending on the result.

Examples of Benign Lesions

Benign lid margin warts and polyps

Benign lid margin warts and polyps

Benign lid margin intradermal naevus

Benign lid margin intradermal naevus

Cyst of Moll right upper lid

Cyst of Moll right upper lid

Pigmented naevus right lower lid

Pigmented naevus right lower lid

Multiple benign lesions from lid margin down: cyst of Moll, blue naevus and red haemangioma

Multiple benign lesions from lid margin down: cyst of Moll, blue naevus and red haemangioma

Sebaceous cyst inner corner of left eye

Sebaceous cyst inner corner of left eye

Keratin horn left lower lid, usually benign but may have a malignant base.

Keratin horn left lower lid, usually benign but may have a malignant base.

Unusual benign pilomatrixoma left lower lid in a child

Unusual benign pilomatrixoma left lower lid in a child

Benign lentigo maligna below right lower lid; may become malignant if left untreated

Benign lentigo maligna below right lower lid; may become malignant if left untreated

 

Management

The management of benign lesions varies considerably. Some lumps or bumps cause no symptoms and once reassured that the problem is harmless many people are happy not to have anything done. In other situations the lesion may be symptomatic eg itchy, irritating, crusty or cosmetically unsightly and the preferred option would be to remove surgically (or occasionally using a laser). Surgery, which would normally be under local anaesthetic as an out-patient, may also be appropriate if there is any doubt about the diagnosis.

Benign epidermoid cyst outer corner right eye

Benign epidermoid cyst outer corner right eye

Same patient with small scar following surgical excision

Same patient with small scar following surgical excision

Benign xanthelasma (fatty deposits) upper lids which can be treated with surgery or laser

Benign xanthelasma (fatty deposits) upper lids which can be treated with surgery or laser

Patient following laser treatment  for xanthelasma deposits in both upper lids

Patient following laser treatment for xanthelasma deposits in both upper lids

Multiple benign intradermal naevi

Multiple benign intradermal naevi

Same patient following surgical removal

Same patient following surgical removal

Rapidly growing benign keratoacanthoma mimicking a malignant lid tumour

Rapidly growing benign keratoacanthoma mimicking a malignant lid tumour

Same patient after wide excision and repair using a skin graft

Same patient after wide excision and repair using a skin graft