Purchase this article with an account.
R. Scartozzi, J.A. Shields, C.L. Shields; Survey of 1264 Patients with Orbital Tumors and Simulating Lesions . Invest. Ophthalmol. Vis. Sci. 2004;45(13):4693.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To determine the incidence of specific orbital tumors based on a large clinical series of patients referred to an ocular oncology center. Methods: A retrospective chart review was done on 1264 consecutive patients referred for a suspected orbital mass over a 30–year period. The lesions were grouped into several categories (see Results section). The specific diagnosis in each case was based on clinical findings, computed tomography, magnetic resonance imaging, and histopathology when available. The number and percent of benign and malignant tumors per age group were also determined. Results: Among 1264 consecutive patients, the number and percent of lesions in each category were as follows: 70 cystic (6%), 213 vasculogenic (17%), 23 peripheral nerve (2%), 105 optic nerve and meningeal (8%), 13 fibrocytic (1%), 21 osseous/fibro–osseous (2%), 1 cartilagenous (<1%), 64 lipocytic/myxoid (5%), 36 myogenic (3%), 114 lacrimal gland (9%), 11 melanocytic (1%), 91 metastatic (7%), 130 lymphoma/leukemia (10%), 142 secondary (11%), 17 histiocytic (1%), 67 thyroid–related orbitopathy (5%), 133 inflammatory lesions (11%), and 13 miscellaneous lesions (1%). The most common specific diagnoses were lymphoid tumor (139 cases; 11%), idiopathic orbital inflammation (135 cases; 11%), cavernous hemangioma (77 cases; 6%), lymphangioma (54 cases; 4%), meningioma (53 cases; 4%), optic nerve glioma (48 cases; 4%), metastatic breast cancer (44 cases; 4%), rhabdomyosarcoma (35 cases; 3%), dermolipoma (31 cases; 3%), herniated orbital fat (30 cases; 2%), dermoid cyst (26 cases; 2%), varix (26 cases; 2%), dacryops (19 cases; 2%). Of the 1264 lesions, 810 (64%) were benign and 454 (36%) were malignant. Of the malignant lesions, 20% occurred in patients 0–18 years of age, 27% in those 19–59 years of age, and 58% in those 60–92 years of age. Rhabdomyosarcoma was the most common specific malignancy in younger patients while lymphoma was the most common malignancy in older patients. Conclusions: A variety of tumors and pseudotumors can involve the orbit. In this series of 1264 lesions, 64% were benign and 36% were malignant. The percent of malignant tumors increased with age due to the higher incidence of lymphomas, secondary, and metastatic lesions in the elderly. It is hoped that the large number of patients in this study will accurately reflect the incidence of the various space–occupying orbital lesions that may prompt an ophthalmologist to refer to an ocular oncology specialist, thus aiding in the construction of a differential diagnosis for the referring physician.
This PDF is available to Subscribers Only