Metastasis to eyelid as initial presentation of non-small cell carcinoma

A 50-year-old man presented with a 1-month history of progressive eyelid swelling and intermittent hemorrhagic epiphora. A 1.2 x 1.3 x 0.7-cm friable hemorrhagic nodule was excised from the posterior eyelid surface. Histopathology revealed a poorly differentiated carcinoma. The patient underwent a systemic workup including CT of the lungs and was subsequently diagnosed with stage IV non-small cell carcinoma presumably of the lung. He received palliative radiation and chemotherapy and died 5 months after initial presentation. This report illustrates a case where metastatic eyelid disease was the presenting sign of hitherto undiagnosed lung cancer. It is followed by a review of clinical aspects of metastatic eyelid disease.