Eyelid Tumors: A Comparative Analysis of Benign and Malignant Cases in a Tertiary Referral Center-Retrospective Study

Objective: To compare the demographic and clinical features of benign and malignant eyelid tumors in a tertiary referral center from 2018-2023. Material and Methods: This retrospective study analyzed medical records of 256 patients who underwent eyelid tumor surgery, with institutional review board approval. Histopathological findings were classified as benign, malignant, or premalignant. Demographic data, tumor characteristics, and recurrence rates were compared between benign and malignant cases. Results: Of the 256 histopathologically confirmed lesions, 191 (74.6%) were benign, 62 (24.2%) were malignant, and 3 (1.2%) were premalignant. Patients diagnosed with malignant tumors were significantly older than those with benign tumors (65.4±13.1 vs. 47.8±19.3 years, p<0.001). The most common benign tumors were xanthelasma (17.8%, n=34), squamous papilloma (17.3%, n=33), and seborrheic keratosis (11.5%, n=22). Among malignant tumors, basal cell carcinoma (BCC) (82.3%, n=51) was most frequent, followed by squamous cell carcinoma (8.1%, n=5) and sebaceous gland carcinoma (6.4%, n=4). Benign tumors were more often found in the upper eyelids and in younger patients (p=0.011), while malignant tumors were more common in the lower eyelids and in older patients (p<0.001). Patients from outside İstanbul had a significantly higher rate of malignant tumors compared to those from İstanbul (p<0.001). Malignant tumors required more extensive excision and reconstruction. Conclusion: BCC was the most common malignant tumor, while xanthelasma and squamous papilloma were the most frequent benign lesions. Malignant tumors, more common in older patients, were often located in the lower eyelids.