Q3 - Orbital Tumors

Question 1

Primary tumors and general symptoms

Answer 1

Hemangiomas, dermoid cysts, nerve tumors (neurinomas, neurofibromas), lacrimal gland tumors, meningiomas, malignant lymphomas and rhabdomyosarcomas.
- they displace eye globe (exophthalmos), and limits ocular motility.

Question 2

Hemangiomas

Answer 2

• Capillary -> most common in children.
• Cavernous -> most common in adults.
  Treated only if they occlude visual axis. Capillary can be treated with steroids and low dose radiation.

Question 3

Dermoid and epidermoid cysts

Answer 3

Most common orbital tumors in children. Are dermal/epidermal structures displaced into deeper layers. Usually anterior to the septum and therefore not in the orbit itself. Surgical removal.

Question 4

Neurinoma and Neurofibromas

Answer 4

Usually associated with Von Recklinghausen disease -> neurofibromatosis, benign nerve sheath tumor of PNS.
If they occur in optic canal they can cause compressive optic neuropathy.

Question 5

Meningiomas

Answer 5

Optic nerve meningiomas are benign tumors arising from arachnoidal cells around the optic nerve (20%) or from extensions of intracranial meningiomas (80%).
May cause exophthalmos, limited motility and compressive neuropathy.

Question 6

Lymphomas

Answer 6

Most commonly in lacrimal gland. They are only slightly malignant, and usually mold themselves around the eye globe margins. Can cause exophthalmos and limited motility.
Exception is Burkitt lymphoma, highly malignant.

Question 7

Rhabdomyosarcomas

Answer 7

Most common malignant tumor in children. Grows rapidly. Painless exophthalmos, ptosis and inflammation.
Chemo/radio.