The role of in vivo confocal microscopy in the diagnosis of eyelid margin tumors: 47 cases

J Am Acad Dermatol. 2014 Nov;71(5):912-918.e2. doi: 10.1016/j.jaad.2014.05.060. Epub 2014 Jul 3.

Abstract

Background: Handheld in vivo reflectance confocal microscopy (IVCM) is a new imaging method that allows noninvasive diagnosis of cutaneous tumors but to date it has not been used in the study of eyelid tumors.

Objective: We sought to evaluate the suitability of IVCM for eyelid margin tumors.

Methods: We prospectively evaluated the IVCM features of 47 eyelid margin lesions, clinically suspicious of malignancy; 35 of these were excised whereas the other 12, with no IVCM malignant features, were followed up for at least 1 year. Clinical, IVCM, and histologic diagnoses were compared.

Results: IVCM showed sensitivity and specificity of 100% and 69.2%, respectively, for malignancy (basal cell carcinoma, squamous cell carcinoma, and melanoma). The follow-up of the 12 nonexcised lesions did not show any clinical progression.

Limitations: The lesions showing neither clinical nor IVCM features for malignancies were not biopsied in view of the potential functional and aesthetic consequences of eyelid margin surgery.

Conclusion: Used with a handheld dermatology-specific microscope, IVCM can play a role in the noninvasive diagnosis of eyelid margin lesions. Further studies are needed to better define diagnostic criteria of eyelid tumors and improve the specificity of this technique.

Keywords: basal cell carcinoma; eyelid; eyelid margin; in vivo; melanoma; mucosa; reflectance confocal microscopy; tumor.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Basal Cell / pathology*
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / surgery
  • Conjunctiva / pathology
  • Conjunctival Neoplasms / pathology*
  • Conjunctival Neoplasms / surgery
  • Eyelid Neoplasms / pathology*
  • Eyelid Neoplasms / surgery
  • Female
  • Humans
  • Male
  • Melanoma / pathology*
  • Melanoma / surgery
  • Microscopy, Confocal* / methods
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Young Adult