Which eyelid cancer is the most common?

• A. Melanoma
• B. Merkel cell carcinoma
• C. Basal cell carcinoma
• D. Adenocarcinoma

Answer: (C)

Basal cell carcinoma is the eyelid cancer seen most often. It tends to arise on sun‑exposed eyelid skin, especially the lower lid, in older individuals with fair skin. It grows slowly and is usually locally destructive if not treated, but it almost never spreads distantly. On exam it often appears as a pearly, translucent bump with visible blood vessels, and central ulceration can occur.

Because this type is the most common eyelid malignancy, clinicians focus on complete excision with clear margins to preserve function and appearance. Mohs micrographic surgery is commonly used for eyelid tumors to maximize tissue conservation while ensuring complete removal.

Other eyelid cancers like melanoma, Merkel cell carcinoma, and sebaceous (adenocarcinoma) carcinoma are less common but tend to be more aggressive and require careful evaluation and management. Melanoma can be pigmented and metastasize; Merkel cell carcinoma is rare but highly aggressive; sebaceous carcinoma often mimics chronic eyelid inflammation and has a tendency for recurrence.