Survey Of 105 Patients With Orbital Space-Occupying Lesions

Purpose:To review 105 cases of orbital space-occupying lesions to determine the distribution of pathology, patient age and tumor location.Methods:A retrospective review was carried out for 105 consecutive patients referred for a suspected orbital mass. We reviewed cases of histopathologically verified orbital space-occupying lesions at our ocular oncology center from 2003 through 2009, and studied the distribution of pathology, patient age and tumor location in the orbit in 105 consecutive patients (aged from 0 to 73 years, mean,30.3 years; 45 men,60 women).Results:Among 105 consecutive patients,89 (84.8%) were primary orbital tumors,14 (13.3%) were secondary tumors, and 2 (1.9%) were metastatic tumors. The most common orbital space-occupying lesions in general category were:vasculogenic,25 cases (23.8%); cystic,19 cases (18.1%); lacrimal gland lesions,16 (15.2%); secondary orbital tumors,14 (13.3%); inflammatory lesions, 13 cases (12.4%). Of the 105 lesions,74 (70.5%) were benign and 31 (29.5%) were malignant. The age distribution of the 105 patients exhibited two peaks, at 0 to 9 years and 40 to 49 years. In the patients younger than 9-year-old, the most common tumors were:retinoblastoma,10 cases (37%), dermoid cyst,4 cases (14.8%), epithelial cyst,3 cases (11.1%), and capillary hemangioma,2 cases (7.4%). On the other hand, in the 40 to 49-year-old patients, the common tumors were:cavernous hemangioma,8 cases (50%) and pleomorphic adenoma,3 cases (18.8%). Based on the consideration of patients'age and tumor locations in the orbit, the common tumors among children younger than 18 years of age were epithelial cyst and dermoid cyst in the extraconal area, retinoblastoma with orbital invasion in the intraconal area, and dermoid cyst in the lacrimal gland area. In addition, the common tumors in patients over 40 years of age were inflammatory pseudotumor in the extraconal area, cavernous hemangioma in the intraconal area, pleomorphic adenoma and adenoid cystic carcinoma in the lacrimal gland area.Conclusion:The most common orbital space-occupying lesions in general category were:vasculogenic lesions, cystic lesions, lacrimal gland lesions, secondary orbital tumors and inflammatory lesions. Cystic lesions and retinoblastoma with orbital spread were the most common causes of orbital space-occupying lesions among the children. The age of onset, tumor location, and imaging findings provide us with important information for the preoperative diagnosis of an orbital tumor and for the determination of the treatment strategy.