Lymph Node Evolution in Eyelid and Orbit Squamous Cell Carcinomas

Area of Science:

• Ophthalmology
• Dermatology
• Head and Neck Surgery

Background:

• Squamous cell carcinoma (SCC) of the eyelid and periorbital region is a common skin malignancy.
• Understanding the patterns and risk factors for lymph node metastasis is crucial for effective management.

Purpose of the Study:

• To characterize a large cohort of eyelid and periorbital SCCs.
• To compare tumor location with pathological lymph node sites.
• To identify risk factors associated with lymph node involvement.

Main Methods:

• Retrospective analysis of patients with eyelid and periorbital SCCs.
• Evaluation of tumor characteristics, imaging, excision margins, and lymph node status.
• Univariate and multivariate analyses to determine risk factors for lymph node involvement.

Main Results:

• 15.7% of patients (18/115) developed lymph node metastasis.
• Parotid gland involvement was most common (88.9%), followed by submental/submandibular (38%) and jugular/carotid areas (22%).
• Risk factors for lymph node metastasis included tumor size >20mm, invasion of canthus/periorbital structures, perineural/vascular invasion, deep infiltration, and local recurrence.

Conclusions:

• Periorbital and eyelid SCCs have a significant potential for lymph node metastasis, primarily via the parotid gland.
• Mandatory inclusion of parotid gland and neck in imaging and assessment is recommended.
• Lymph node dissection should be considered in cases of parotidectomy for confirmed lymph node involvement.