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Die Ophthalmologie Feb 2023
Topics: Humans; Orbital Diseases; Orbital Neoplasms
PubMed: 35394197
DOI: 10.1007/s00347-022-01607-5 -
Canadian Journal of Ophthalmology.... Apr 2020To report one of the largest case series on periorbital and orbital dermoid/epidermoid cyst and to highlight some important and unusual findings. (Review)
Review
OBJECTIVE
To report one of the largest case series on periorbital and orbital dermoid/epidermoid cyst and to highlight some important and unusual findings.
METHODS
Retrospective analysis of 280 cases with orbital or periorbital dermoid/epidermoid cyst that presented over a period of 14 years.
RESULTS
Periorbital cyst was more than twice as common as orbital cyst. Majority of patients had bony changes with some unusual findings seen in cases with orbital cysts, that is, presence of fluid-fluid level, calcification in the wall, and coexistent double cysts in 19 (6.8%), 5 (1.8%), and 4 (1.5%) cases, respectively. Dumbbell dermoid cyst with connection in temporal fossa was seen in 16 (5.7%) cases. Subperiosteal location of orbital dermoid cyst was most destructive because of extensive bony invasion. Most of the periorbital cysts were removed in toto, whereas orbital cysts required decompression before removal. The histopathological diagnosis was dermoid cyst in 250 (89%) cases and epidermoid cyst in 30 (11%) cases. In 69 (25%) cases, there was a chronic inflammatory response.
CONCLUSIONS
We recommend imaging in all patients with orbital dermoid to rule out dumbbell or subperiosteal extension. Also, we advocate early removal of all dermoid cysts in view of bone changes seen in majority of our cases and presence of inflammatory cells in 25% of cases.
Topics: Adolescent; Adult; Child; Child, Preschool; Dermoid Cyst; Epidermal Cyst; Female; Humans; Infant; Male; Middle Aged; Orbital Diseases; Orbital Neoplasms; Retrospective Studies; Tomography, X-Ray Computed; Young Adult
PubMed: 31712044
DOI: 10.1016/j.jcjo.2019.08.005 -
Canadian Journal of Ophthalmology.... Dec 2020
Topics: Humans; Orbital Neoplasms; Teratoma
PubMed: 32853589
DOI: 10.1016/j.jcjo.2020.06.019 -
Orbit (Amsterdam, Netherlands) Apr 2022To present the application of computer-assisted surgery (CAS) in pre-operative planning, intra-operative navigation, and post-operative assessment as an adjunct tool in...
PURPOSE
To present the application of computer-assisted surgery (CAS) in pre-operative planning, intra-operative navigation, and post-operative assessment as an adjunct tool in orbital surgery.
METHODS
An IRB-approved, retrospective review was performed to identify patients who had undergone orbital surgery by a single surgeon from July 2013 to December 2019 with attention to pre-operative virtual surgical planning, intra-operative navigation, and post-operative assessment. The reasons and methods of CAS use were classified.
RESULTS
The use of computer-assisted technologies was identified in 91 cases out of 464 orbital surgeries (19.6%). This included 23 (25.3%) orbital decompression surgeries, 39 (42.9%) fracture repairs, and 25 (27.5%) orbital tumors. In all cases, pre-, intra-, and post-operative CAS allowed for increased operative efficiency and safety with good outcomes.
CONCLUSIONS
Use of CAS in orbital surgery can allow for complex radiographic analysis and in select cases is a great tool to add to the orbital surgeon's armamentarium.
Topics: Humans; Orbit; Orbital Fractures; Orbital Neoplasms; Plastic Surgery Procedures; Surgery, Computer-Assisted
PubMed: 34256667
DOI: 10.1080/01676830.2021.1939730 -
Survey of Ophthalmology 2019The orbit can harbor mass lesions of various cellular origins. The symptoms vary considerably according to the nature, location, and extent of the disease and include... (Review)
Review
The orbit can harbor mass lesions of various cellular origins. The symptoms vary considerably according to the nature, location, and extent of the disease and include common signs of proptosis, globe displacement, eyelid swelling, and restricted eye motility. Although radiological imaging tools are improving, with each imaging pattern having its own differential diagnosis, orbital mass lesions often pose a diagnostic challenge. To provide an accurate, specific, and sufficiently comprehensive diagnosis, to optimize clinical management and estimate prognosis, pathological examination of a tissue biopsy is essential. Diagnostic orbital tissue biopsy is obtained through a minimally invasive orbitotomy procedure or, in selected cases, fine needle aspiration. The outcome of successful biopsy, however, is centered on its representativeness, processing, and interpretation. Owing to the often small volume of the orbital biopsies, artifacts in the specimens should be limited by careful peroperative tissue handling, fixation, processing, and storage. Some orbital lesions can be characterized on the basis of cytomorphology alone, whereas others need ancillary molecular testing to render the most reliable diagnosis of therapeutic, prognostic, and predictive value. Herein, we review the diagnostic algorithm for orbital mass lesions, using clinical, radiological, and pathological recommendations, and discuss the methods and potential pitfalls in orbital tissue biopsy acquisition and analysis.
Topics: Biopsy, Fine-Needle; Diagnosis, Differential; Humans; Orbital Neoplasms
PubMed: 31276737
DOI: 10.1016/j.survophthal.2019.06.006 -
Journal of the College of Physicians... May 2021Orbital teratoma is a rare tumour that is composed of tissues derived from all three germ cell layers. It presents, in otherwise, healthy neonates with unilateral...
Orbital teratoma is a rare tumour that is composed of tissues derived from all three germ cell layers. It presents, in otherwise, healthy neonates with unilateral proptosis that progresses rapidly, threatening vision through optic nerve compromise or exposure keratopathy. Globe conservation may be difficult too in advanced cases. Mature teratomas are benign, but the immature ones can sometimes become malignant. We report a case of a six-month female infant who presented with mature orbital teratoma since birth. Vision could not be salvaged; but following complete surgical excision, good cosmesis was achieved. Key Words: Mature teratoma, Orbit, Congenital tumour, Surger.
Topics: Dermoid Cyst; Exophthalmos; Female; Humans; Infant; Infant, Newborn; Orbit; Orbital Neoplasms; Teratoma
PubMed: 34027878
DOI: 10.29271/jcpsp.2021.05.596 -
BMJ Case Reports Jun 2022Rhabdomyosarcoma is the most common soft-tissue sarcoma in paediatric patients and may arise as a primary orbital neoplasm. Imaging studies show a unilateral solitary...
Rhabdomyosarcoma is the most common soft-tissue sarcoma in paediatric patients and may arise as a primary orbital neoplasm. Imaging studies show a unilateral solitary orbital lesion. With larger tumours, erosion of the adjacent orbital walls is a common accompanying bony change. We present an unusual case of rhabdomyosarcoma in a preschool girl with proptosis and temporal bossing. Imaging studies showed a homogeneous, well-delineated, extraconal mass of the right orbit with hyperostosis of the adjacent sphenoid bone. After excision of the mass and debulking of the sphenoid bone, histopathology showed embryonal rhabdomyosarcoma with no malignant infiltration of the adjacent bone. This is the first reported case of hyperostosis associated with rhabdomyosarcoma. Periosteal reaction is the proposed underlying mechanism.
Topics: Child; Child, Preschool; Female; Humans; Hyperostosis; Orbit; Orbital Neoplasms; Rhabdomyosarcoma; Rhabdomyosarcoma, Embryonal; Tomography, X-Ray Computed
PubMed: 35725289
DOI: 10.1136/bcr-2021-245466 -
Journal of Nepal Health Research Council Jun 2022Orbital tumors have rare incidence, still they play a significant role in terms of morbidity and mortality. Orbital tumors may be primary, secondary or metastatic. These...
BACKGROUND
Orbital tumors have rare incidence, still they play a significant role in terms of morbidity and mortality. Orbital tumors may be primary, secondary or metastatic. These consist of benign and malignant lesions with extreme variations in pediatric and adult groups. These lesions can have acute or chronic onset, slow to rapid progression with or without bony destructions leading to vision loss, deformity and sometimes death.
METHODS
This retrospective cross-sectional study was carried out in the Department of Ophthalmic Pathology and Laboratory Medicine in Biratnagar Eye Hospital. Fifty-one patients who underwent histopathological evaluation for their orbital lesions from June 2018 to December 2019 were included in the study.
RESULTS
Orbital tumor and tumor like lesions comprised 27 cases (52.94%) in adults and 24 (47.06%) in paediatrics. Histopathologically, the most common pediatric benign tumor was dermoid cyst and malignant was secondary to orbital extension of retinoblastoma. Also, the most common adult benign orbital tumor was cavernous hemangioma and malignant was non Hodgkins lymphoma. The clinico-pathological accuracy for diagnosis was 68.63%. Association between age groups and nature of orbital lesions and between clinical and histopathological diagnosis was found to be statistically significant (p<0.05).
CONCLUSIONS
Orbital tumors and tumor like lesions are uncommonly encountered. These masses showed significant variation in incidence in children versus adults. Combined efforts by different specialties help in early and prompt management of the orbital tumors.
Topics: Adult; Child; Cross-Sectional Studies; Hospitals; Humans; Nepal; Orbital Neoplasms; Retrospective Studies
PubMed: 35945849
DOI: 10.33314/jnhrc.v20i01.3727 -
Eye (London, England) Jul 2021To investigate the clinical features, prognostic outcomes of patients with orbital and ocular adnexal lymphoma (OALs) in Taiwanese cohort. (Review)
Review
PURPOSE
To investigate the clinical features, prognostic outcomes of patients with orbital and ocular adnexal lymphoma (OALs) in Taiwanese cohort.
METHODS
Total 112 patients with OALs were retrospectively reviewed. Demographic information such as age, gender, lymphoma subtype, tumor location and treatment modalities were recorded. The primary endpoints were disease-specific survival (DSS), and progression-free survival (PFS).
RESULTS
The mean patient age was 59.0 ± 15.5 years (range, 23-92 years). The major histopathologic subtypes were mucosa-associated lymphoid tissue (MALT) lymphoma in 76 patients (67.9%), followed by diffuse large B-cell lymphoma (DLBCL) (9.8%), follicular cell lymphoma (FL) (8.0%), and small lymphocytic lymphoma (SLL) (5.4%). The anatomical locations for OALs were the orbit (44 patients, 39.3%), the conjunctiva (31 patients, 27.7%), the lacrimal gland (28 patients, 25.0%), and the eyelid (8 patients, 7.1%). With a mean follow-up time of 74.5 ± 59.8 months (range 6-342 months), the DSS for all patients were 93.1%, 87.7%, and 68.8% at 60, 120, and 180 months' follow-up, respectively. The PFS at 60, 120, and 180 months' follow-up were 86.2%, 61.2%, and 44.6%, respectively. Regarding the analysis of prognostic factors, patients with high grade lymphoma subtype and advanced stage exhibited a worse prognosis.
CONCLUSIONS
MALT type lymphoma constitutes most of OALs in Taiwan and occurs more frequently than in Western countries. Patients with MALT lymphoma, FL, SLL and earlier stage have favorable outcomes compared with patients of high grade lymphoma and Ann Arbor stage IV lymphoma.
Topics: Adult; Aged; Aged, 80 and over; Eye Neoplasms; Humans; Lymphoma, B-Cell, Marginal Zone; Middle Aged; Orbital Neoplasms; Prognosis; Retrospective Studies; Taiwan; Young Adult
PubMed: 32994547
DOI: 10.1038/s41433-020-01198-y -
Klinische Monatsblatter Fur... Nov 2019Orbital disorders in childhood include various pathologies. Whereas neoplastic lesions and structural anomalies (which frequently cause strabismus) predominate in...
Orbital disorders in childhood include various pathologies. Whereas neoplastic lesions and structural anomalies (which frequently cause strabismus) predominate in newborns and infants, vascular lesions become more common in toddlers. Inflammatory lesions are less common than in adults and affect mostly older children and adolescents. The most common orbital mass in infants and young children is a dermoid cyst, a benign lesion.Rhabdomyosarcoma as the most common primary orbital malignancy and neuroblastoma as a common metastasis to the orbit should be considered in children with new onset orbital space-occupying lesions.Capillary hemangioma and lymphangioma (lymphatic malformation) are relatively common vascular orbital lesions in children. Novel therapeutic options include systemic betablockers for capillary hemangioma and sirolimus for lymphangioma. In contrast to adults, external signs of an orbital fracture may be absent or mild in children. If ocular motility restriction after orbital trauma is present in a child without obvious external signs, a "white-eye blowout fracture" of the orbit should be considered and requires prompt surgical repair if present.Inflammatory disorders of the orbit such as thyroid-related orbitopathy and idiopathic orbital inflammation are uncommon in young children and occur more frequently in adolescents. In young children, amblyopia may complicate any orbital disease. It should be treated using part-time occlusion or pharmacologic penalisation of the fellow eye and the underlying cause should be addressed.
Topics: Adolescent; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Lymphangioma; Orbit; Orbital Diseases; Orbital Neoplasms; Rhabdomyosarcoma
PubMed: 31412385
DOI: 10.1055/a-0972-4774