Orbit is small compact anatomical structure composed of bone and soft tissue, each of which can give rise to a neoplasm. Broadly, the neoplasms of the orbit can be classified into two categories: Benign and malignant. Benign lesions can be of inflammatory or infectious etiology or may be tumors, and malignant lesions are largely divided on histopathology into round cell and spindle cell neoplasms which belong to carcinoma, sarcoma, or the lymphoma group. Most of the malignant lesions are aggressive in nature and can locally spread to adjacent structure or metastasizes to distant vital organs. The tumors of orbit produce symptoms of a mass lesion and therefore result in proptosis or in globe dystopia. At times there can be compression over vital structures of the orbit such as the optic nerve or the eyeball and this can lead to visual symptoms and signs. At times the tumors can involve the extraocular muscles and lead to limitation in eye movement. Finally, tumors of the orbit can also erode the bony orbit and spread to the nasal cavity, temporal fossa or the intracranial cavity and have symptoms related to these anatomic spaces. For example in cases of adenoid cystic carcinoma of lacrimal gland globe displacement or proptosis occurs due to the mass effect of the enlarged lacrimal gland or bony erosion due to the malignant nature of the tumor. Patients may also present with pain that happens due to the perineural invasion by the tumor. As against this in a case of a low-grade lymphoma, since the growing mass tends to mold around the globe there may not be signs of a mass lesion and proptosis may be missed for quite some time while the mass is growing and the only visible sign of a tumor might be a salmon on patch of infiltrative tumor in the fornices of the eye. While a clinic-radiological suspicion helps narrow down the list of possible diagnoses, histopathology remains the gold standard. In several cases an immune workup is essential to clinch the diagnosis. In this chapter we hope to describe the common orbital tumors that a clinician is faced with and discuss the clinical features with the histologic findings of these tumors, but covering of all topics is beyond the scope of this book.

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Orbital Lesions and Their Pathology

  • Dilip K. Mishra,
  • Tarjani Vivek Dave,
  • Neha Ghose

摘要

Orbit is small compact anatomical structure composed of bone and soft tissue, each of which can give rise to a neoplasm. Broadly, the neoplasms of the orbit can be classified into two categories: Benign and malignant. Benign lesions can be of inflammatory or infectious etiology or may be tumors, and malignant lesions are largely divided on histopathology into round cell and spindle cell neoplasms which belong to carcinoma, sarcoma, or the lymphoma group. Most of the malignant lesions are aggressive in nature and can locally spread to adjacent structure or metastasizes to distant vital organs. The tumors of orbit produce symptoms of a mass lesion and therefore result in proptosis or in globe dystopia. At times there can be compression over vital structures of the orbit such as the optic nerve or the eyeball and this can lead to visual symptoms and signs. At times the tumors can involve the extraocular muscles and lead to limitation in eye movement. Finally, tumors of the orbit can also erode the bony orbit and spread to the nasal cavity, temporal fossa or the intracranial cavity and have symptoms related to these anatomic spaces. For example in cases of adenoid cystic carcinoma of lacrimal gland globe displacement or proptosis occurs due to the mass effect of the enlarged lacrimal gland or bony erosion due to the malignant nature of the tumor. Patients may also present with pain that happens due to the perineural invasion by the tumor. As against this in a case of a low-grade lymphoma, since the growing mass tends to mold around the globe there may not be signs of a mass lesion and proptosis may be missed for quite some time while the mass is growing and the only visible sign of a tumor might be a salmon on patch of infiltrative tumor in the fornices of the eye. While a clinic-radiological suspicion helps narrow down the list of possible diagnoses, histopathology remains the gold standard. In several cases an immune workup is essential to clinch the diagnosis. In this chapter we hope to describe the common orbital tumors that a clinician is faced with and discuss the clinical features with the histologic findings of these tumors, but covering of all topics is beyond the scope of this book.