• Six hundred forty-five consecutive biopsies of orbital lesions performed at a major ophthalmic hospital during a 20-year period were used to develop a comprehensive classification of orbital tumors and pseudotumors, excluding thyroid orbitopathy. Although this series has certain bias, it probably closely parallels the incidence of orbital lesions that would prompt a biopsy in an ophthalmic practice. It is hoped that this review, combined with a familiarity of the signs and symptoms of various orbital lesions, will aid the clinician in the diagnostic evaluation of the patient with an orbital mass.
A Danish nation-wide 20-year series of orbital tumours in infancy is reported, making up a total of 80 histopathologically verified cases. Secondary tumours were not included except for a few cases where the initial manifestation of the disease was an orbital mass, suggesting a primary tumour of the orbit. A scant half of the series were benign choristomas. Otherwise there was a considerable share of more serious diseases, often threatening vision and/or life; thus ten embryonal sarcomas and nin...
A 9-year-old boy who had had painless progressive proptosis of the right eye for 18 months, initially diagnosed as fibrous dysplasia, was found to have a circumscribed mass involving the frontal bone in the roof of the orbit. Biopsy of the mass led to the diagnosis of juvenile ossifying fibroma and the tumor was removed by a craniotomy approach. One year after surgery, the child appeared to be healthy. Ossifying fibroma can sometimes be differentiated from fibrous dysplasia both clinically and b...
This is a clinicopathologic study of 150 cases of fibrous histiocytoma of the orbit. The tumors occurred in adults (median age, 43 years). The upper and nasal portions of the orbit were the most common sites of involvement. The most common signs and symptoms were proptosis (60 per cent), mass (46 per cent), and decreased vision (25 per cent). Based on the histopathologic features, the tumors were classified in three groups: benign (94 cases), locally aggressive (39 cases), and malignant (17 case...
Although metastatic cancer to the uvea is reported to be the most common intraocular malignancy, most ophthalmologists have had little experience with its diagnosis and treatment. This report describes our experience with the diagnosis and management of 70 patients with metastatic cancer to the uvea. Many patients were evaluated with modern diagnostic modalities such as fluorescein angiography, ultrasonography, and the 32 P test when indicated. Thirty-one percent of patients had no history of pr...
: An 18-year-old woman had a rapidly progressive proptosis, vascular congestion, and orbital pain. Ultrasonographic and radiologic tests supported the diagnosis of a solid vascularized mass that proved histologically to be an alveolar soft-part sarcoma of the orbit. Uncertainty as to the histogenesis of alveolar soft-part sarcoma still exists, but prognosis for patient survival is poor.
: Orbital rhabdomyosarcoma presenting as a localized, epibulbar mass is unusual, but common enough for the clinician to be aware of it. Although there has been a recent trend toward simple biopsy followed by irradiation and chemotherapy, cases presenting in this manner may sometimes be managed by total excision with preservation of the globe, follwed by irradiation and chemotherapy. A case of such an epibulbar rhabdomyosarcoma is presented as an illustrative example.
• A 31-year-old woman had a mass in the posterior inferior orbit that progressively increased in size for almost two years. Histopathologic examination of an orbital biopsy specimen showed pleomorphic neoplastic cells arranged in a storiform pattern. The tumor cells were composed of hyperchromatic nuclei with prominent nucleoli and admixtures of fibroblasts. Electron microscopy demonstrated histiocyte-like cells with complex infoldings of plasma membrane, prominent mitochondria and golgi, and fr...
: A 3 1/2-year-old white girl presented with unilateral proptosis and an orbital tumor that was diagnosed histopathologically as an unusual form of glioma of the optic nerve. The optic foramen was not enlarged but the ultrasonogram indicated a definite retrobulbar mass.
This report describes a patient with a meibomian gland carcinoma that presented clinically as a lacrimal gland tumor with only minimal involvement of the adjacent eyelids. There was metastatic involvement of a right preauricular lymph node. Initial biopsy examinations of both the lacrimal gland and the preauricular node revealed a poorly differentiated carcinoma, primary site undetermined. Orbital exenteration, however, revealed that the lesion was a multifocal sebaceous carcinoma involving both...
An adolescent girl with no medical history presented to our institution with right upper eyelid swelling and pain. She initially went to an external ophthalmological clinic, where she was given eye medications due to the suspicion of ocular herpes. After receiving eye medications, her right eye
This case report demostrates an unusual occurence of orbital metastasis along with liver metastasis 5 years following enucleation for ciliochoroidal melanoma with no extraocular extension. It exemplifies that metastasis of the tumour can occur in the ipsilateral orbit after enucleation. Importance of close clinical follow-up after enucleation for choroidal melanoma, careful socket examination, and regular systemic metastatic workup is demonstrated. To the best of our knowledge, this is the first...
This article provides an overview of rare orbital diseases. Congenital malformations, inflammatory diseases, benign and malignant neoplasias are described. Although it represents a relatively small area of the body the orbit contains multiple different tissues. Therefore, a great variety of diseases can be found within the orbital space. That is the reason, why both the completeness and the level of detail in the description of particular diseases must be somewhat limited. Nevertheless, clinical...
Objective Primary orbital malignancy is rare. Awareness of the characteristic clinical and imaging features is imperative for timely identification and management. Surgery remains an important diagnostic and treatment modality for primary orbital malignancy, but determining the optimal surgical approach can be challenging. The purpose of this article is to explore recent advances in the diagnosis, management, and surgical approaches for primary orbital malignancies. Design In this review, the cl...
#10Jason G. Newman(UPenn: University of Pennsylvania)H-Index: 25
OBJECTIVES Primary orbital melanoma (POM) is a rare disease with limited data on survival and best treatment practices. Here we utilize the National Cancer Database (NCDB) to determine the overall survival (OS) and covariates that influence mortality. STUDY DESIGN Retrospective cohort study. METHODS All patients diagnosed with POM from 2004 to 2016 were identified in the NCDB. Patient and oncologic data were analyzed using the Kaplan-Meier method and multivariate models for the primary outcome o...
BACKGROUND Metastatic disease to the eye most commonly involves choroid followed by orbit leading to varied ocular manifestations. By comparison, it is relatively rarer than primary malignancies of eye as well as metastasis in other parts of the body. AIM The aim of this study is to evaluate the common eye and orbital structures involved in secondary ocular and metastatic disease, to describe its clinical manifestations and outline the management done. METHODS A retrospective study of newly diag...
Purpose: The majority of pediatric patients with optic nerve gliomas (ONG) remain asymptomatic; however, a subset of patients suffer rapid, irreversible visual loss. The purpose of this stu...
