[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [General pathology](https://durgical.com/en/general-pathology/) › [Eye](https://durgical.com/en/general-pathology/areas/eye/) › Tumours of the eyelid and conjunctiva # Tumours of the eyelid and conjunctiva - Lesion Most eyelid cancers are basal cell carcinomas; sebaceous carcinoma can look like a simple chalazion and must not be missed. Updated Nov 12, 2026 ## Key points - Basal cell carcinoma: lower lid and inner corner; nests of basaloid cells with peripheral palisading; invades locally, rarely metastasises. - Sebaceous carcinoma: upper lid, older adults; foamy vacuolated cells, pagetoid spread into epidermis and conjunctiva; can metastasise; recurrent chalazion in an older adult needs biopsy. - Ocular surface squamous neoplasia: limbal, sun exposure, HPV and HIV are risks; from intraepithelial dysplasia to invasive squamous carcinoma. - Conjunctival melanoma: from primary acquired melanosis with atypia or nevi; pigmented lesions in the fornix or palpebral conjunctiva are suspicious; spreads to lymph nodes. - Conjunctival lymphoma: salmon-pink patch, usually MALT lymphoma; Kaposi sarcoma in AIDS. ## What it is The eyelid is skin on the outside and conjunctiva on the inside, with specialised sebaceous (meibomian) glands between. Its tumours follow those of skin: basal cell carcinoma is by far the commonest, usually on the lower lid. Sebaceous carcinoma, rarer but more dangerous, mimics chalazion or chronic blepharitis and spreads within the epithelium. The conjunctiva gives rise at the limbus to squamous neoplasia (from dysplasia to carcinoma), melanocytic lesions (nevus, primary acquired melanosis, melanoma), lymphoma and Kaposi sarcoma. ## Structure - Chalazion, the main mimic: lipogranuloma around extruded sebum, with histiocytes and giant cells around clear lipid spaces. - Xanthelasma: lipid-laden macrophages in the dermis of the inner lids; may signal dyslipidemia. ## Tumours of the eyelid and conjunctiva | Tumour | Usual site | Key histology | Behaviour | | --- | --- | --- | --- | | [Basal cell carcinoma](https://durgical.com/en/conditions/basal-cell-carcinoma/) | Lower lid, medial canthus | Basaloid nests with palisading | Locally invasive | | [Sebaceous carcinoma](https://durgical.com/en/conditions/chalazion-and-hordeolum/) | Upper lid | Vacuolated cells, pagetoid spread | Can metastasise; mimics chalazion | | Squamous cell carcinoma of the lid | Lower lid | Keratinising squamous cells | Local and nodal spread | | Ocular surface squamous neoplasia | Limbus | Dysplasia to invasive carcinoma | Recurs; rarely metastasises | | [Conjunctival melanoma](https://durgical.com/en/conditions/melanoma/) | Bulbar, fornix or palpebral conjunctiva | Atypical melanocytes | Regional nodes, distant spread | | [Conjunctival lymphoma](https://durgical.com/en/conditions/non-hodgkin-lymphoma/) | Fornix, salmon patch | Monoclonal B cells (MALT) | Indolent | | [Kaposi sarcoma](https://durgical.com/en/conditions/kaposi-sarcoma/) | Conjunctiva or lid | Spindle cells, slit-like vessels, HHV-8 | Linked to HIV | ## Markers - Adipophilin and EMA (sebaceous carcinoma) - BerEP4 (basal cell carcinoma) - SOX10, HMB-45, Melan-A (melanoma) - HHV-8 LANA (Kaposi sarcoma) ## Clinical notes - A lid lesion with loss of lashes, ulceration or recurrence is biopsied. - Sun protection lowers the risk of eyelid and conjunctival cancers, important in high-altitude equatorial regions. ## Memory aid Basal sits low on the lid and stays local; sebaceous sits high, wears a chalazion mask and can travel. ## Test yourself Think of the answer, then tap the question to see it. ## What is the most common malignant tumour of the eyelid? Basal cell carcinoma, usually on the lower lid. ## Why can sebaceous carcinoma be missed? It mimics a chalazion or chronic blepharitis and spreads within the epithelium (pagetoid spread). ## Where do conjunctival squamous and melanocytic neoplasms usually start? At the limbus, the junction of cornea and conjunctiva, which holds epithelial stem cells. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/general-pathology/tumours-of-the-eyelid-and-conjunctiva/) [More Pathology questions →](https://durgical.com/en/practice/?f=pathology) ## Elsewhere in DurgiPedia - [The orbit, orbital septum and eyelids](https://durgical.com/en/ophthalmology/the-orbit-orbital-septum-and-eyelids/) - [Conjunctiva, eyelid glands and lacrimal gland](https://durgical.com/en/histology/conjunctiva-eyelid-glands-and-lacrimal-gland/) ## Connections ## Related 9 - [Conjunctiva: conjunctivitis, trachoma and pterygium](https://durgical.com/en/general-pathology/conjunctiva-conjunctivitis-trachoma-and-pterygium/) - [Orbital disease](https://durgical.com/en/general-pathology/orbital-disease/) - [Basal cell carcinoma](https://durgical.com/en/general-pathology/basal-cell-carcinoma/) - [Adnexal tumours of the skin](https://durgical.com/en/general-pathology/adnexal-tumours-of-the-skin/) - [Melanoma: subtypes, Breslow and markers](https://durgical.com/en/general-pathology/melanoma-subtypes-breslow-and-markers/) - [Actinic keratosis and squamous cell carcinoma](https://durgical.com/en/general-pathology/actinic-keratosis-and-squamous-cell-carcinoma/) - [Kaposi sarcoma](https://durgical.com/en/general-pathology/kaposi-sarcoma/) - [Marginal zone lymphomas](https://durgical.com/en/general-pathology/marginal-zone-lymphomas/) - [Radiation and cancer: ultraviolet and ionizing](https://durgical.com/en/general-pathology/radiation-and-cancer-ultraviolet-and-ionizing/) ## Related conditions 7 - [Basal cell carcinoma](https://durgical.com/en/conditions/basal-cell-carcinoma/) - [Chalazion and hordeolum (stye)](https://durgical.com/en/conditions/chalazion-and-hordeolum/) - [Melanoma](https://durgical.com/en/conditions/melanoma/) - [Kaposi sarcoma](https://durgical.com/en/conditions/kaposi-sarcoma/) - [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/) - [Non-Hodgkin lymphoma](https://durgical.com/en/conditions/non-hodgkin-lymphoma/) - [Blepharitis](https://durgical.com/en/conditions/blepharitis/) ## Microorganisms 1 - [Human papillomavirus](https://durgical.com/en/microbiology/human-papillomavirus/) [← All of general pathology](https://durgical.com/en/general-pathology/) Educational content on the mechanisms of disease; not a diagnostic or treatment guide and no substitute for a health professional's advice. No doses are given. Sources: [Chalazion](https://www.ncbi.nlm.nih.gov/books/NBK499889/) (StatPearls (NCBI Bookshelf), 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/general-pathology/tumours-of-the-eyelid-and-conjunctiva/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/general-pathology/tumours-of-the-eyelid-and-conjunctiva/