The management of lid and conjunctival malignancies

Adnexal tumors are relatively rare in a general eye practice, and the most important component in their management is early recognition. The clear differentiation between stimulating lesions and lid or conjunctival tumors can be difficult. Any recurrent lid inflammation, chronic lid ulcer, chronic unilateral keratoconjunctivitis, or a suspicious pigmented conjunctival lesion should be biopsied. The choice of treatment in lid and conjunctival tumors is partially dependent on the available surgical expertise. Lid tumors can be treated with either surgery (using frozen section control), radiation, or cryotherapy. Conjunctival tumors should first be biopsied, then treated with surgery or radiation. Exenteration is rarely indicated in the management of conjunctival tumors. A metastatic evaluation should precede possible exenteration, especially if this procedure is planned because of a recurrent or large conjunctival melanoma.