Neglected squamous cell carcinoma of the eyelid

An 89-year-old woman was referred with several years' history of enlarging lesions on her right eyelid. The patient did not seek medical aid during disease progression. On admission, a large, ulcerated lesion was seen on her right upper eyelid, covering the globe completely, and the eye was completely blind and hypotonous. A fine-needle biopsy of the lesion was performed. Histopathologic evaluation of the eyelid lesion disclosed a poorly differentiated squamous cell carcinoma. The patient refused any surgical intervention and was treated with electron beam radiotherapy (a total of 4000 cGy) with some decrease in the size of the eyelid and skin tumors. After 2 weeks of hospitalization, the patient was followed-up at home and died 2 weeks later of unknown causes. Squamous cell carcinoma of the periocular region can follow a fulminant course in advanced, neglected cases.