Basal cell carcinoma is the most common skin cancer of the eyelid constituting 90% of the skin cancer of the eyelid. Exposure to sunlight is the most important causitive factor and the lower lid is effected most often. Several clinical varients can be seen: nodular, nodular ulcerative, plaquelike or morpheaform , and multicentric. The nodular has palisating nuclei at the base of each island of tumor cells. An artifactual separation of the islands can be seen between nests of tumor cells and the surrounding dermis (cracking artifact). In the morpheaform varient, the tumor invades the dermis with branching cords and fingerlike projections. Often there is dermal fibrosis involved. This form is more difficult to treat due to the diffuse infiltration. It is extremely rare for these to metastasize, however they do invade locally and into the orbit as well as into the cranial cavity if left unchecked. Back to Eyelid