A case of primary squamous cell carcinoma of the eyelid conjunctiva with parotid and cervical lymph node metastases

Although malignancies of the eyelid are relatively rare, it is necessary to know the characteristics of eyelid malignancy because head and neck surgeons are required to treat patients with cervical lymph node metastases. We report a case of primary squamous cell carcinoma of the lower eyelid conjunctiva with parotid and cervical lymph node metastases. The patient was an 80-year-old woman. She had been diagnosed as having conjunctivitis with eye discharge in the left eye for about 6 months and had been under observation at her local ophthalmologist. Two to three months ago, she noticed swelling of the left preauricular and upper neck, and was referred to our department. A 15-mm-large protruded lesion on the left lower eyelid conjunctiva, a hard nodule in the parotid gland, and enlarged lymph nodes in the upper-left cervical region were found, all of which were diagnosed as squamous cell carcinoma by fine-needle aspiration cytology. With the diagnosis of squamous cell carcinoma of the lower eyelid with metastases to the parotid gland and cervical lymph nodes, the patient underwent resection of the malignant lower eyelid tumor, total parotidectomy, neck dissection on the affected side, and reconstruction of the lower eyelid with a hard palatal mucosal flap and malar flap. Postoperative radiation therapy was performed on the affected side of the neck, and the patient is currently undergoing outpatient follow-up with no signs of recurrence for approximately one year after the surgery.