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Indian Journal of Ophthalmology Feb 2022Dermoid cyst, a developmental benign choristoma, is the most common orbital tumor of childhood, arising from ectodermal sequestration along the lines of embryonic fusion...
BACKGROUND
Dermoid cyst, a developmental benign choristoma, is the most common orbital tumor of childhood, arising from ectodermal sequestration along the lines of embryonic fusion of mesodermal processes, lined by keratinized stratified squamous epithelium and expanding slowly due to constant desquamation and dermal glandular elements. Approximately 80% are found in the head and neck region and comprise 3-9% all orbital masses.
PURPOSE
It is mandatory to know about the variable presentations of orbital dermoids and the surgical techniques that can be adopted based on the site, extent, age and aesthetic needs, presence of inflammation and possibility of intraoperative rupture.
SYNOPSIS
Orbital dermoids can be classified as juxta-sutural, sutural or soft tissue cysts; superficial or deep; intraosseous or extraosseous, and intraorbital or extraorbital. These smooth, painless, mobile or partially mobile lesions mostly present at the fronto-zygomatic suture with proptosis, displacement, ptosis or diplopia, depending on depth and extent. Therefore, it is important to understand the various presentations and the appropriate surgical techniques.
HIGHLIGHTS
We describe the embryological origin, types and clinical features of dermoids in this video and demonstrate the surgical and minimally invasive techniques for their management.
VIDEO LINK
https://youtu.be/-q3xD2igjcQ.
Topics: Blepharoptosis; Choristoma; Dermoid Cyst; Humans; Orbital Diseases; Orbital Neoplasms
PubMed: 35086291
DOI: 10.4103/ijo.IJO_145_22 -
Middle East African Journal of... 2018Incidental orbital masses that are asymptomatic and appear benign are often observed without surgical intervention unless there is a clinical or radiographic change in... (Review)
Review
Incidental orbital masses that are asymptomatic and appear benign are often observed without surgical intervention unless there is a clinical or radiographic change in the mass. There is a burgeoning population of cancer patients with incidental masses that have been detected while under surveillance for metastasis. This population of patients is growing due to a number of reasons, including more extensive imaging, an aging population, and more effective cancer treatments. Closer scrutiny should be applied to these patients, due to the possibility of the mass being an orbital metastasis. In addition, the approach to these patients may have implications regarding the adult patient without a cancer history who presents with a symptomatic orbital mass. The purpose of this paper is to explore the approach to the patient with and without a cancer history who presents with an orbital mass.
Topics: Biopsy; Decision Making; Humans; Neoplasm Metastasis; Orbital Diseases; Orbital Neoplasms
PubMed: 30122850
DOI: 10.4103/meajo.MEAJO_93_18 -
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 -
Orbit (Amsterdam, Netherlands) 2016A 44-year-old male patient presented with painless progressive proptosis of left eye for the last 20 years. Examination revealed a purplish vascular mass extending from...
A 44-year-old male patient presented with painless progressive proptosis of left eye for the last 20 years. Examination revealed a purplish vascular mass extending from the medial orbital region to the surface of the globe. He underwent complete excision of the mass via an anterior orbitotomy approach. Histopathology and immunohistochemistry revealed a diagnosis of angioleiomyoma. No recurrence was noted at 1 year of follow-up. Angioleiomyomas are benign smooth muscle tumors with an additional vascular component. Their occurrence in the orbit is extremely rare with only three cases reported in literature till date. We report a fourth case of angioleiomyoma of the orbit with the longest duration of presentation of 20 years.
Topics: Adult; Angiomyoma; Diagnosis, Differential; Humans; Magnetic Resonance Imaging; Male; Ophthalmologic Surgical Procedures; Orbital Neoplasms; Rare Diseases
PubMed: 26927953
DOI: 10.3109/01676830.2016.1139137 -
Archives of Iranian Medicine Feb 2015At an estimated incidence of 2 cases per million persons per year, osteosarcoma is the most common primary malignant bone tumor in children and adults, excluding...
At an estimated incidence of 2 cases per million persons per year, osteosarcoma is the most common primary malignant bone tumor in children and adults, excluding hematopoietic intraosseous tumors. Orbital metastases of osteosarcoma are very rare. Only 5 cases of orbital metastasis of osteosarcoma previously reported in the literature. We report the case of a 19-year-old man with known history of osteosarcoma of right distal femur who presented with acute visual loss and progressive protrusion of his left eye. Orbital CT scan and MRI revealed orbital mass eroding orbital walls and intracranial invasion. He underwent superotemporal orbitotomy for debulking of orbital mass. Histopathological examination (HPE) of the specimen was reported as metastatic osteosarcoma with extensive tumor necrosis. Then he underwent adjuvant chemotherapy and palliative radiotherapy. Although orbital metastasis of osteosarcoma is a rare event, it seems it has had an increasing trend recently. so, making efforts to palliate the patient's symptoms by multidisciplinary teamwork and proper interaction among ophthalmologist, orthopedic surgeons and oncologists is necessary.
Topics: Humans; Male; Necrosis; Neoplasm Metastasis; Ophthalmologic Surgical Procedures; Orbit; Orbital Neoplasms; Osteosarcoma; Surgical Flaps; Tomography, X-Ray Computed; Young Adult
PubMed: 25644802
DOI: No ID Found -
Radiographics : a Review Publication of... Oct 2013Orbital neoplasms in adults may be categorized on the basis of location and histologic type. Imaging features of these lesions often reflect their tissue composition.... (Review)
Review
Orbital neoplasms in adults may be categorized on the basis of location and histologic type. Imaging features of these lesions often reflect their tissue composition. Cavernous malformations (also known as cavernous hemangiomas), although not true neoplasms, are the most common benign adult orbital tumor. They typically appear as a well-circumscribed, ovoid intraconal mass on cross-sectional images. Lymphoma, which may be primary or secondary to systemic disease, is the most prevalent orbital neoplasm in older adults (≥60 years of age). Choroidal melanoma is the most common primary adult ocular malignancy. Melanin has intrinsic T1 and T2 shortening effects, classically manifesting with hyperintense signal on T1-weighted magnetic resonance (MR) images and with hypointense signal on T2-weighted images. However, amelanotic or mildly pigmented lesions of melanoma do not demonstrate these characteristic MR imaging features. Breast cancer is the most common malignancy to metastasize to the orbit, followed by prostate cancer, melanoma, and lung cancer. In women with bilateral enophthalmos, metastatic scirrhous breast cancer should be considered in the differential diagnosis. Neoplasms that arise from the optic nerve or its sheath include glioma and meningioma. At imaging, gliomas often cause fusiform expansion of the optic nerve, in which the nerve itself cannot be delineated from the lesion. In contrast, meningiomas classically have a "tram-track" configuration, whereby the contrast-enhancing tumor is seen alongside the optic nerve. Neoplasms that derive from peripheral nerves include schwannoma and neurofibroma, the latter of which is associated with neurofibromatosis type 1. MR imaging is particularly valuable for evaluation of orbital neoplasms, as it provides critical anatomic information about ocular structures involved, perineural spread, and intracranial extension.
Topics: Adult; Diagnosis, Differential; Diagnostic Imaging; Humans; Orbital Neoplasms
PubMed: 24108560
DOI: 10.1148/rg.336135502 -
Orbit (Amsterdam, Netherlands) 2008To report a case of intermediate grade meningeal melanocytoma presenting as a recurrent orbital mass.
PURPOSE
To report a case of intermediate grade meningeal melanocytoma presenting as a recurrent orbital mass.
INTRODUCTION
Melanocytomas are rare, primary, pigmented tumors of the central nervous system, usually presenting as well-circumscribed, encapsulated, solid masses in the posterior cranial fossa and at the spinal region, often attached to the underlying dura. Orbital manifestation is rarely encountered.
METHODS
Case report with computed tomography scan, magnetic resonance imaging, histology, and immunohistochemistry.
RESULTS
A 40-year-old man presented with a recurrent orbital mass manifesting as progressive proptosis of the right eye of 4 years duration. The computed tomography scan and magnetic resonance imaging revealed an intraconal mass in the superior quadrant of the orbit. Histological analysis of the excision biopsy of the mass showed a highly cellular, locally infiltrating melanocytic neoplasm suggestive of an intermediate grade meningeal melanocytoma. Immunohistochemical staining for S-100 protein and HMB-45 monoclonal antibody confirmed the diagnosis.
CONCLUSIONS
Recurrent intermediate grade orbital melanocytomas are rarely encountered and have to be distinguished from other topographically similar primary melanotic tumors. They have to be managed more aggressively if intracranial extension is present due to its close relation to the visual pathways.
Topics: Adult; Antigens, Neoplasm; Biomarkers, Tumor; Humans; Magnetic Resonance Imaging; Male; Melanoma-Specific Antigens; Neoplasm Proteins; Neoplasm Recurrence, Local; Nevus, Pigmented; Orbital Neoplasms; S100 Proteins; Tomography, X-Ray Computed; Visual Acuity
PubMed: 18836939
DOI: 10.1080/01676830802333626 -
Neuro-Chirurgie 2010Orbital metastases are uncommon, accounting for 4% of all adult orbital tumors. The mean age at time of presentation is 60 years. The primary tumor is most often a...
Orbital metastases are uncommon, accounting for 4% of all adult orbital tumors. The mean age at time of presentation is 60 years. The primary tumor is most often a carcinoma involving the breast (40%), lung (11%), or prostate (8%). Proptosis is the main clinical sign at diagnosis and is often associated with visual impairment, pain or ptosis. Imaging features are not specific; nevertheless, an enhanced extraconal tumor with osteolysis suggests the diagnosis. From a pathological point of view, there are no differences between the metastasis and the primary tumor. Regarding the average survival, the gold standard treatment remains radiotherapy.
Topics: Adenocarcinoma; Age of Onset; Aged; Breast Neoplasms; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Metastasis; Orbital Neoplasms; Prostatic Neoplasms; Tomography, X-Ray Computed
PubMed: 20304446
DOI: 10.1016/j.neuchi.2010.02.008 -
Asia-Pacific Journal of Ophthalmology... 2017The aim of this review article is to provide an update of the current literature on orbital tumors. The authors conducted a PubMed literature search of English language... (Review)
Review
The aim of this review article is to provide an update of the current literature on orbital tumors. The authors conducted a PubMed literature search of English language articles published between January 2014 and December 2016 using the following search items: orbit, tumors, lacrimal gland, lymphoma, hemangioma, lymphangioma. The authors included reviews, original articles, case series, and case reports with relevant new information. There is new information about the clinical spectrum of orbital tumors, capillary hemangioma, cavernous hemangioma, lymphangioma, orbital venous malformation, lacrimal gland tumors, and orbital lymphoma. This review highlights the current understanding, practice, and guidelines in the diagnosis and management of common tumors of the orbit.
Topics: Global Health; Humans; Morbidity; Neoplasm Staging; Ophthalmology; Orbital Neoplasms; Periodicals as Topic
PubMed: 28399335
DOI: 10.22608/APO.201736 -
Tierarztliche Praxis. Ausgabe K,... Dec 2018A 10-year-old Rottweiler presented with right-sided moderately painful exophthalmia, blindness, absence of dazzle and pupillary light reflexes, a swollen optic nerve...
A 10-year-old Rottweiler presented with right-sided moderately painful exophthalmia, blindness, absence of dazzle and pupillary light reflexes, a swollen optic nerve head and ventrolateral indentation of the globe. On magnetic resonance imaging, a 3 x 2 x 2 cm mass with a fluid filled center and contrast-enhancing periphery was noted posteriolateral of the globe. Orbital ultrasound was used for a guided fine needle aspirate of the mass. Cytology revealed moderate numbers of polygonal cells with lightly basophilic cytoplasm. Several cells showed nuclear pseudoinclusions. Histopathology following exenteration of the orbit revealed an infiltrative, extradural neoplasm surrounding the optic nerve. Cells were arranged in packets. Neoplastic cells were immunopositive for neuron specific enolase, synaptophysin and chromogranin A and immunonegative for cytokeratin. Findings were consistent with an extra-adrenal paraganglioma (neuroendocrine tumour). Although complete excision could not be confirmed on histopathology, the owners reported no apparent tumour recurrence 25 months after surgery. In conclusion a paraganglioma should be considered as a differential diagnosis of an orbital mass.
Topics: Animals; Diagnosis, Differential; Dog Diseases; Dogs; Female; Orbital Neoplasms; Paraganglioma, Extra-Adrenal
PubMed: 30658369
DOI: 10.1055/s-0038-1677406