Orbit, Eyelids and Lacrimal system 3 Flashcards
list adult orbital tumors
- dermal cysts
2. cavernous hemangioma
most common benign neoplasm in adults
cavernous hemangioma
cavernous hemangioma
- Slowly progressive proptosis
2. Often in middle aged women
cavernous hemangioma located
- Retinal striae
- hyperopia (farsightedness)
- optic nerve compression
- increased IOP
- strabismus
cavernous hemangioma is diagnosed with
CT or MRI – well encapsulated mass that is enhancing with vasculature on MRI
Neural Tumors affecting the orbit
- Meningiomas (primary orbital)
- Mengangiomas (sphenoid wing)
- Schwannoma
- Neurofibroma
- Optic nerve glioma
Meningiomas (primary orbital)
- Less common
- Usually along arachnoid of optic sheath
- Women in 3rd and 4th decades of life
- Gradual, unilateral loss of vision, painless
Meningiomas (primary orbital)
treatment
- Observe if no vision loss or spread
- Radiation if confined to orbit
- Surgery if severe vision loss and profound proptosis
Mengangiomas (Sphenoid wing)
- Hyperplasia of soft tissue and bone
- Crawls along lateral wall of orbit
- Dural tail
Mengangiomas (Sphenoid wing) Treatment
- Observe until functional problem
- Subtotal resection
- Post-op radiotherapy to reduce recurrence
Schwannoma
- Proliferation of Schwann cells encapsulated by perineurium
- Biphasic pattern or solid areas and myxoid areas
- Hypercellular
- Excised easily
Lymphoproliferative Disorders
treatment
- Radiotherapy
- Surgery not curative as these are infiltrative
- Chemo if aggressive
Lymphoproliferative Disorders
- can involve orbit
- Usually B cell tumor
a. Hodgkin and NH Lymphoma
b. Malignant NH Lymphoma very common lymphoproliferative disease of orbit! - T-cell tumors are rare
4 most common lymphomas that go to orbit:
- MALT
- CLL
- Follicular center lymphoma
- High grade lymphoma
Lacrimal Gland tumors
Epithelial tumors or non epithelial tumors
Secondary orbital tumors
Extended to orbit from adjacent structure
- Globe or eyelid
- Sinuses
Globe or eyelid secondary orbital tumors
- Choroidal melanoma
- Retinoblastoma
- Basal and squamous cell carcinomas
metastatic orbital tumor
- breast and lung are most orbital metastasis
2. pain, proptosis, inflammation, bone destruction
Congenital nasolacrimal obstruction
- Constant tearing with mucopurulence
2. Dacryocystocele
Constant tearing with mucopurulence
90% resolves in the first year
Dacryocystocele
- Enlargement of nasolacrimal sac at birth
- Obstruction of canaliculus proximally and nasal valve of Hasner distally
- Fluid trapped in sac = tears and amniotic fluid
- Large, bluish, cystic structure
Dacryocystocele complications
Can get intranasal cyst problem since babies are obligate nose breathers
Dacryocystocele is caused by
Complications of preseptal cellulitis, orbital cellulitis and intranasal cyst
