Search

Purpose: Orbital metastasis secondary to thyroid carcinoma is an exceedingly rare occurrence. In this case report, we present a rare isolated orbital metastasis of papillary thyroid carcinoma (PTC). Methods: A case report and literature review study. Result: A 55-year-old female, who presented with right-sided exophthalmos persisting for seven months and a week-long history of decreased visual acuity. Orbital computed tomography (CT) revealed a solid, isolated, well-circumscribed mass confined to the right intra-conal orbital cavity. Surgical excision via lateral orbitotomy confirmed the diagnosis of metastatic PTC. Conclusion: Most cases reported in the literature have identified orbital masses concurrently with the initial diagnosis of thyroid carcinoma. In contrast, our patient exhibited ocular symptoms following a prolonged interval after normal post ablative iodine imaging, highlighting a significant delay in metastatic presentation. Moreover, the solid and well-defined nature of the metastatic orbital mass, confined solely to the orbital cavity without evidence of bony destruction, muscle involvement or intracranial extension in this patient, constitutes a distinctive clinical feature rarely documented in existing case reports. [ABSTRACT FROM AUTHOR]

Summary: The study analysed the clinical characteristics, treatment approaches, and survival outcomes of 97 consecutive patients with orbital lymphoma (OL) over a 25-year period at. The median age of the patients was 57.6 years, and 59.8% (n = 58) were male. Marginal zone lymphoma constitutes the most prevalent subtype, accounting for 67% of cases, whereas other common subtypes include diffuse large B-cell lymphoma, follicular lymphoma, mantle cell lymphoma, Burkitt lymphoma, and T-cell lymphomas. Unilateral involvement was observed in the majority of cases (72.3%). Common clinical presentations included mass (30.9%), swelling (26.8%), and epiphora (11.3%). Of the patients, 7.2% received rituximab alone, 14.4% received radiotherapy alone, 48.5% received chemotherapy, 27.8% received radiotherapy plus rituximab, 22.7% received radiotherapy plus chemotherapy, and 5.2% underwent surgery as the first-line treatment. During a median follow-up of 4.3 years, 15.5% of patients experienced relapse or disease progression. The 5-year and 10-year progression-free survival rates were 84.1% and 79.1%, respectively. This study contributes to our understanding of OLs and provides a foundation for further investigations in this field. Male gender, presence of B symptoms, advanced stage, secondary orbital lymphoma, aggressive histological subtype, and elevated serum lactate dehydrogenase levels were associated with poorer (either inferior or worse) progression-free survival. [ABSTRACT FROM AUTHOR]

Sebaceous carcinoma is a rare cutaneous malignancy which is typically regarded as relatively aggressive and has traditionally been subdivided into periorbital or extraorbital tumours. We conducted a retrospective review of all cases of sebaceous carcinoma reported to the Western Australian Cancer Registry between 1987 and May 2019. The incidence of sebaceous carcinoma in Western Australia has increased over the last three decades, with extraorbital tumours being much more common than periorbital tumours. Very few sebaceous carcinomas have led directly to the death of patients; however, adverse outcomes were more likely with periorbital tumours, in particular local recurrence and the need for major surgical intervention. [ABSTRACT FROM AUTHOR]

Objective: The transnasal endoscopic approach may provide better visualisation and a safer approach to the orbital apex. This study presents a case series of orbital apex lesions managed by this approach. Method: This study was an eight-year retrospective analysis of seven patients who were operated on for orbital apex lesions in two tertiary medical centres. Results: Complete tumour removal was performed in three patients and partial removal was performed in four patients. Visual acuity improved in three patients, remained stable in one patient and decreased in the other two patients. The visual field improved in four patients and did not change in two patients. Complications included worse vision and visual fields in 28.6 per cent of patients and late enophthalmos (of −1.25 ± 4.6 mm) in 2 patients. Conclusion: The transnasal approach to orbital apex lesions in selected cases may provide a rational alternative to transorbital surgery. Complete tumour removal should be weighed against the risk of damage to the optic nerve. [ABSTRACT FROM AUTHOR]

Objectives: To differentiate OCVM from other orbital lesions using structural MRI. Methods: This IRB-approved a historical-prospective cohort single-center analysis of a prospective cohort that included consecutive adult patients presenting with an orbital lesion undergoing a 3T MRI before surgery from December 2015 to May 2021. Two readers blinded to all data read all MRIs assessing structural MRI characteristics. A univariate analysis followed by a stepwise multivariate analysis identified structural MRI features showing the highest sensitivity and specificity when diagnosing OCVM. Results: One hundred ninety-one patients with 30/191 (16%) OCVM and 161/191 (84%) other orbital lesions were included. OCVM were significantly more likely to present with a higher signal intensity than that of the cortex on T2WI: 26/29 (89.7%) versus 28/160 (17.5%), p < 0.001, or with a chemical shift artifact (CSA): 26/29 (89.7%) versus 16/155 (10.3%), p < 0.001, or to present with a single starting point of enhancement, as compared to other orbital lesions: 18/29 (62.1%) versus 4/159 (2.5%), p = 0.001. The step-wise analysis identified 2 signatures increasing performances. Signature 1 combined a higher signal intensity than that of the cortex on T2WI and a CSA. Signature 2 included these two features and the presence of a single starting point of enhancement. Sensitivity, specificity, and accuracy were 0.83, 0.94, and 0.92 for signature 1 and 0.97, 0.93, and 0.93 for signature 2, respectively. Conclusion: Structural MRI yields high sensitivity and specificity when diagnosing OCVM. Key Points: • Structural MRI shows high sensitivity and specificity when diagnosing orbital cavernous venous malformation. • We identified two signatures combining structural MRI features which might be used easily in routine clinical practice. • The combination of higher signal intensity of the lesion as compared to the cortex on T2WI and of a chemical shift artifact yields a sensitivity and specificity of 0.83 and 0.94 for the diagnosis of orbital cavernous venous malformation, respectively. [ABSTRACT FROM AUTHOR]

Objective: To assess the deaths caused by eye cancer from 2010 to 2019 in Brazil. Methods: Data were selected from SUS' Computer Department platform at the Ministry of Health, including death certificates, from 2010 to 2019, from all Brazilian states and the Federal District, filtering the codes C69.0 to C69.9 as the cause of death, according to the International Classification of Diseases, Tenth Revision. Results:There were 1,859 deaths from malignant neoplasm of eye and adnexa (C69), in Brazil, from 2010 to 2019, affecting 1,062 (57.1%) men. The site of neoplasm was unspecified (C69.9) in 719 cases, representing the most frequent etiology in the C69 group (38.67%). The malignant neoplasm of the orbit (C69.6) was the second most common cause of death (22.59%), followed by malignant neoplasm of retina (C69.2) (14.73%). Conclusion: The number of deaths due to malignant neoplasm of eye and adnexa slightly increased through the years of 2010 to 2019, in Brazil. [ABSTRACT FROM AUTHOR]

The IgG4-related disease (IgG4-RD) is an established fibroinflammatory condition, characterised by tumefactive lesion with elevated serum IgG4 level and characteristic histopathological features. The malignant potential of IgG4- RD has been questionable. Low-grade lymphomas are commonly reported orbital malignancy that occurs in IgG4- RD. We describe a case of diffuse large B-cell lymphoma (DLBCL) associated with chronic inflammation arising within IgG4-RD of the orbit. The case highlights the association of high-grade lymphoma in chronic inflammatory condition, focussing on IgG4-RD, that is rarely documented in the orbital region, and the importance of biopsy reassessment in patients with longstanding and worsening proptosis. [ABSTRACT FROM AUTHOR]

The systematic classification of vascular disease as proposed and refined by the International Society for the Study of Vascular Anomalies (ISSVA) divides vascular pathology first into tumors and malformations. Malformations are described as simple and complex, where simple malformations contain a single vascular system and complex malformations comprised of multiple vascular systems. Arteriovenous malformations are considered in terms of inflow characteristics which are primarily responsible for the key management challenges. Management utilizing endovascular embolization and/or surgical resection is often employed; however, recurrence can occur, particularly in diffuse cases. There may be an increasing role for systemic antiangiogenic therapy in such cases. Lymphaticovenous malformations are divided into the principle components on the lymphatic and venous sides for clarity of discussion. Lymphatic malformations are described morphologically as macrocystic and microcystic, and physiologically in terms of the processes responsible for growth. In both cases, surgical options are challenging and local therapeutics intended to close large luminal spaces in the case of macrocystic and to slow biological signaling for growth in microcystic. Venous malformations are described physiologically in terms of flow and distensibility, as volume plays a critical role in the limited space of the orbital cavity. Combined embolic-surgical approaches can be effective for management. More complicated, combined lesions can be managed by dividing the lesion into principal components and treating each appropriately. [ABSTRACT FROM AUTHOR]

Objectives: To determine the diagnostic accuracy of MRI intravoxel incoherent motion (IVIM) when characterizing orbital lesions, which is challenging due to a wide range of locations and histologic types. Methods: This IRB-approved prospective single-center study enrolled participants presenting with an orbital lesion undergoing a 3-T MRI prior to surgery from December 2015 to July 2019. An IVIM sequence with 15 b values ranging from 0 to 2000 s/mm2 was performed. Two neuroradiologists, blinded to clinical data, individually analyzed morphological MRIs. They drew one region of interest inside each orbital lesion, providing apparent diffusion coefficient (ADC), true diffusion coefficient (D), perfusion fraction (f), and pseudodiffusion coefficient (D*) values. T test, Mann-Whitney U test, and receiver operating characteristic curve analyses were performed to discriminate between orbital lesions and to determine the diagnostic accuracy of the IVIM parameters. Results: One hundred fifty-six participants (84 women and 72 men, mean age 54.4 ± 17.5 years) with 167 orbital lesions (98/167 [59%] benign lesions including 54 orbital inflammations and 69/167 [41%] malignant lesions including 32 lymphomas) were included in the study. ADC and D were significantly lower in malignant than in benign lesions: 0.8 × 10−3 mm2/s [0.45] versus 1.04 × 10−3 mm2/s [0.33], p < 0.001, and 0.75 × 10−3 mm2/s [0.40] versus 0.98 × 10−3 mm2/s [0.42], p < 0.001, respectively. D* was significantly higher in malignant lesions than in benign ones: 12.8 × 10−3 mm2/s [20.17] versus 7.52 × 10−3 mm2/s [7.57], p = 0.005. Area under curve was of 0.73, 0.74, 0.72, and 0.81 for ADC, D, D*, and a combination of D, f, and D*, respectively. Conclusions: Our study showed that IVIM might help better characterize orbital lesions. Key Points: • Intravoxel incoherent motion (IVIM) helps clinicians to assess patients with orbital lesions. • Intravoxel incoherent motion (IVIM) helps clinicians to characterize orbital lymphoma versus orbital inflammation. • Management of patients becomes more appropriate. [ABSTRACT FROM AUTHOR]

We present a case of an orbital mass confirmed as Castleman disease (CD) with the histopathological and immunohistochemical review. CD in the orbit is uncommon and has been seldom reported. The case we present justifies the review due to the abnormal location and clinical presentation. Variety of the differential diagnoses that can arise from an orbital mass with these characteristics are also discussed. [ABSTRACT FROM AUTHOR]

This is a 10-year retrospective review to correlate clinical features, imaging and pathologic findings in lesions of the orbit in order for a more accurate diagnosis. Eighty-three patients undergoing biopsy or orbitotomy between September 2000 and August 2010 for orbital lesions were evaluated clinically, radiologically (CT) and histopathologically to determine the correlation between the three modalities. There was complete correlation for all cases under congenital orbital tumours and lacrimal gland and sac tumours that were studied. Negative correlation between clinical diagnosis and final histopathology was seen most significantly in lymphoproliferative disorders and orbital inflammation. The most commonly misdiagnosed type of orbital lesion is lymphoproliferative disorder and orbital inflammation, whereas the least commonly misdiagnosed type of orbital lesion is congenital and lacrimal gland and sac tumours. There was significant disparity between clinical diagnosis and radiology report, however, relatively less disparity between histopathology report and clinical diagnosis. [ABSTRACT FROM AUTHOR]

Background: The aneurysmal bone cyst is an uncommon benign lesion that represents a small percentage of primary bone tumors. It has a higher incidence in long bones and spine, and it is usually diagnosed in young patients. Location in the cranial region accounts for around 2% of the total of aneurysmal bone cysts. It manifests clinically as lumps that vary in size in the majority of patients. Case report: A 13-yearold boy with a history of infl ammatory changes, without pain, and proptosis, in left eye. A biopsy was performed and the histopathological study confi rmed the diagnosis of aneurysmal bone cyst. The left front-naso-orbital location, gives an added value to the rarity of the case. The treatment was surgical, and we achieved a complete removal of the tumor. The patient had an excellent evolution and recovery after the surgery. This case is considered rare and infrequent, which little information exists in the literature. [ABSTRACT FROM AUTHOR]

Objectives: To assess the value of the MR-based radiomics signature in differentiating ocular adnexal lymphoma (OAL) and idiopathic orbital inflammation (IOI).Methods: One hundred fifty-seven patients with pathology-proven OAL (84 patients) and IOI (73 patients) were divided into primary and validation cohorts. Eight hundred six radiomics features were extracted from morphological MR images. The least absolute shrinkage and selection operator (LASSO) procedure and linear combination were used to select features and build radiomics signature for discriminating OAL from IOI. Discriminating performance was assessed by the area under the receiver-operating characteristic curve (AUC). The predictive results were compared with the assessment of radiologists by chi-square test.Results: Five radiomics features were included in the radiomics signature, which differentiated OAL from IOI with an AUC of 0.74 and 0.73 in the primary and validation cohorts respectively. There was a significant difference between the classification results of the radiomics signature and those of a radiology resident (p < 0.05), although there was no significant difference between the results of the radiomics signature and those of a more experienced radiologist (p > 0.05).Conclusions: Radiomics features have the potential to differentiate OAL from IOI.Key Points: • Clinical and imaging findings of OAL and IOI often overlap, which makes diagnosis difficult. • Radiomics features can potentially differentiate OAL from IOI non invasively. • The radiomics signature discriminates OAL from IOI at the same level as an experienced radiologist. [ABSTRACT FROM AUTHOR]

Primary orbital cystic tumors caused by Echinococcus granulosus are rare. As this parasite is endemic in Peru, we report the case of a 10-year-old girl from a rural area of Huancavelica, who presented with progressive and irreducible axial proptosis of the right eye and loss of vision. Orbital tomographic images demonstrated a tumor mass with a cystic appearance. Serologic tests were negative. The patient underwent surgical resection, and histopathologic analysis revealed anhistic membranes, corresponding to hydatid cysts. During one year of follow-up, no evidence of local or systemic recurrence was observed. In conclusion, orbital hydatidosis should be considered in the differential diagnosis of a cystic orbital tumor in pediatric patients, especially if the patient is from an endemic area. [ABSTRACT FROM AUTHOR]

Lipoma is a usually painless benign adipose tumor. Nevertheless, it can cause compression of adjacent structures, depending on its location. Mucoceles are benign cystic lesions in the frontal-ethmoidal region, caused by chronic obstruction of the paranasal sinus and consequent inflammatory processes. The increase of mucocele diameter caused by inflammation often results in bony degradation and reabsorption, increasing pressure on adjacent structures, including the orbit and the base of the skull, leading to possibly serious consequences. Here we report a case of lipoma mimicking a frontal mucocele, managed surgically at the Ophthalmological Hospital of Anapolis. [ABSTRACT FROM AUTHOR]

Objective: To describe causes of orbital exenteration in a Brazilian tertiary hospital. Methods: A retrospective study was done, involving patients submitted to orbital exenteration at the Clinical Hospital of Botucatu Medical School, between the years of 1993 to 2016. The surgeries have been performed under general anesthesia, by a multidisciplinary team, composed by ophthalmologists, otolaryngologists and head and neck surgeons. Results: Fourteen cases of orbital exenteration occurred in the period of the study, with a mean age of 63.36 ± 13.18 years and nine were men (64.3%). All exenteration were due to malignant tumors, being more frequent the squamous cell carcinoma (7 cases - 50.0%). The most common primary sites were the eyelids (50.0%) followed by the conjunctiva (28.6%). The majority of the surgeries was extended exenteration type (57.1%) and most of the reconstructions was made by spontaneous granulation (64.3%). The survivor rate in 1 year was 78,6% and in 5 years was 71.4%. Conclusion: The main cause of orbital exenteration was squamous cell carcinoma and the most frequent primary site was the eyelids. Extended exenteration was necessary for the majority of cases, most of them with free margins. [ABSTRACT FROM AUTHOR]

Orbital wall defects occur because of trauma and secondary to oncologic surgery. Reconstruction of orbital bones is of most importance to ensure normal eye functions and cosmesis. Acrylic resin materials can be used instead of a bone in orbital wall defects that are secondary to the resection of tumors invading the orbita. Polymethyl methacrylate is one of the acrylic resin materials. In this study, the orbital wall reconstruction technique with bone cement after maxillectomy and results are reported. [ABSTRACT FROM AUTHOR]

A 66-year-old woman with breast cancer presented with a painless mass in the left orbit. MRI revealed a well-defined intraconal mass in the temporal quadrant of the orbit. Fifteen months later, a further MRI indicated the mass had grown, displacing the left optic nerve and making contact with the lateral rectus muscle, suggesting its possible intramuscular origin. Despite the clinical and radiological characteristics of the lesion and its slow growth, a PET/CT study was developed because of the history of malignant disease. No metabolic activity of the mass or malignant lesion in other locations was observed. After surgical excision, histopathological examination revealed an abundant myxoid matrix with few spindle-shaped cells and no signs of malignancy. The cells were immunopositive for CD34, positive for S-100 protein, and negative for EMA, actin, and CD57. A diagnosis was made of a nerve sheath myxoma. The orbital location of these tumors is extremely rare. [ABSTRACT FROM AUTHOR]

Among the tumors that compromise the orbit, the majority is primary or reaches it through contiguousness, being the metastatic disease uncommon, with incidence varying between 1-13%. Most metastasis occurs in the uveal tract, being rare the invasion of soft orbital tissues. The breast is the most common primary cancer site source for orbital metastasis, with incidence between 8-10%. The case of a patient with breast cancer orbital metastasis is reported, appearing 26 years after the diagnosis of the primary tumor, treated with chemotherapy, evolving with recurrence four years after the treatment. [ABSTRACT FROM AUTHOR]

Computed tomography-guided percutaneous biopsy is a safe and effective alternative method for evaluating selected intra-orbital lesions where the preoperative diagnosis is important for the therapeutic planning. The authors describe two cases of patients with uncommon primary orbital tumors whose diagnosis was obtained by means of computed tomography-guided core needle biopsy, with emphasis on the technical aspects of the procedure. [ABSTRACT FROM AUTHOR]

Aim: The aim of this review was to present the radiological findings of patients with histopathologically proven dermoid and epidermoid cysts in periorbital and intraobital region. Methods: We evaluated 9 patients who underwent computed tomography (CT) or magnetic resonance imaging (MRI) of the orbit and were diagnosed with orbital dermoid and epidermoid cyts between August 2010 and March 2012. The radiological findings together with the histopathological findings were evaluated in light of the literature. Results: Three patients were women and 6 were men. The mean age of the subjects was 19.3 years (13-29 years). Before treatment, MRI or CT of the orbit was performed in all patients. The lesions were divided into two groups: superficially located and profoundly located. The radiological findings were evaluated according to the location of the lesions. Conclusion: Epidermoid and dermoid cysts are rare benign tumors, representing 3 to 9% of all orbital tumors. These tumors are most often located adjacent to the lateral orbital wall, and may rarely be found in deep orbital cavity. These lesions grow slowly and occasionally do erode adjacent bone and sutures. Radiological recognition of the lesions and to know possible complications are important in the diagnosis and follow-up. [ABSTRACT FROM AUTHOR]

To examine the clinicopathologic characteristics and clinical features of epithelial tumors of lacrimal gland in China. The retrospective case series study included all 298 patients of epithelial lacrimal gland tumors which had been collected in the ophthalmic pathologic laboratory of the Tongren Hospital Beijing in the study period from 1961 to 2005. Pleomorphic adenomas were the most common tumors ( n = 213 (72%)), followed by adenoid cystic carcinoma ( n = 58 (20%)), pleomorphic adenocarcinoma ( n = 13 (4%)), primary adenocarcinoma ( n = 8 (3%)) and other tumors ( n = 6 (2%)). The most frequent symptoms and clinical signs were restrictions of the lid or eye motility (121 patients; 41%), any other kind of lid involvement (71 patients; 24%), swelling (57 patients; 19%), pain (57 patients; 8%), and decrease in vision (15 patients; 5%). A restriction of the eye motility was noted for 61 patients (21%), due to an involvement of the extraocular muscles with the tumor and due to a tumor-induced displacement of the globe. Apart from the duration of symptoms, the tumor types did not vary significantly in age, gender, and laterality. Based on the archives of the Beijing Tongren ophthalmo-pathological laboratory, the most common epithelial tumors of the lacrimal gland in mainland China were pleomorphic adenomas, followed by adenoid cystic carcinoma. The spectrum and clinical signs of epithelial lacrimal gland tumors did not differ markedly between Chinese patients and Caucasian patients. [ABSTRACT FROM AUTHOR]

The purpose of this study is to report a intraorbital melanoma case with atypical and aggressive presentation, forming a large painful mass with erythematosus and inflammatory aspect protruding from the left orbit with eyeball damaged at its peak. Piece analysis identified malignant melanoma compound of epithelioid, spindle and anaplastic cells. [ABSTRACT FROM AUTHOR]

PurposeTo evaluate the diagnostic value of magnetic resonance imaging (MRI) and illustrate the common MRI features of orbital schwannoma.MethodsWe reviewed 62 consecutive cases of pathologically proven orbital schwannoma investigated by MRI. All cases were examined using T1- and T2-weighted images. Enhanced T1-weighted images were obtained after administration of gadopentetate dimeglumine. The images were analysed and compared.ResultsCone-shaped lesions were the most frequent (16, 26%), followed by dumbbell-shaped (10, 16%), oval (9, 15%) and round lesions (8, 13%). The most common site was the superior aspect of the orbit (17, 27%), followed by the medial superior (12, 19%) and the orbital apex (12, 19%). On unenhanced T1-weighted images, 53 (85%) lesions showed isointensity or small patches of hypointensity. The patterns of enhancement seen on T1-weighted images correlated with the signal characteristics of unenhanced T2-weighted images. Five patterns emerged in our series. Among these patterns, the most common sign, found in 18 (29%) cases, was peripheral (ring) enhancement on enhanced T1-weighted images, which showed peripheral isointensity with central hyperintensity on T2-weighted images. Lesions with homogeneous or heterogeneous enhancement were seen in 16 (26%) and 26 (42%) cases, respectively.ConclusionsMRI is a valuable diagnostic method for orbital schwannoma, particularly when contrast is applied. The locations and shapes of tumours can be seen distinctly. T1-weighted images are relatively nonspecific. T2-weighted and enhanced T1-weighted images provide information about the pathology of tumours. In particular, peripheral enhancement should be considered a target sign of schwannoma.Eye (2008) 22, 1034–1039; doi:10.1038/sj.eye.6702832; published online 20 April 2007 [ABSTRACT FROM AUTHOR]

Background. Radiation retinopathy is vasculopathy induced by ionising radiation delivered by either brachytherapy or teletherapy for ocular and nonocular malignancies. The first signs of radiation retinopathy typically occur a few months to a few years after the exposure to ionizing radiation. Case report. In the 3 of our patients, changes like capillary telangiectasia, microaneurysms, intraretinal hemorrhages, hard exudation, and capillary nonperfusion showed a clinical picture of macular edema. Two of the patients were suspected of diabetic retinopathy, and 1 patient had optic neuropathy. In our group of patients a latent period was between 3 and 8 years. The incidence of radiation retinopathy increases significantly with the total doses of radiation above 45 Gy, and, thus, it has not been found in the lower doses. Conclusion. Radiation retinopathy is a diagnostical and therapentical problem. Clinical picture can be identical to that of diabetic retinopathy suggesting a common pathophysiologic mechanism of the damage to capillary endothelial cells, and the importance of clinical examination, anamnesis and fluorescein angiography. [ABSTRACT FROM AUTHOR]

Orbital leiomyoma is a benign tumour of smooth muscle origin that can be clinically, radiologically and histopathologically difficult to diagnose due to the rarity of leiomyomas in this location. A 74-year-old woman presented with a 2-month history of painless proptosis. Computed tomography and magnetic resonance imaging studies revealed a well-circumscribed intraconal lesion separate from the optic nerve, and not eroding adjacent bone. A right lateral orbitotomy via a lid crease incision was performed to remove the firm lobulated lesion. Postoperatively there was an obvious decrease in proptosis. Microscopically the lesion was a well-circumscribed tumour composed of spindle cells. There were no light microscopic features to suggest malignancy, and immunohistochemistry was used to confirm the diagnosis of leiomyoma. Leiomyoma is a tumour that is rarely found in the orbit most likely due to the paucity of smooth muscle in this location. The differential diagnosis is wide, and the role of radiology, histology and immunohistochemistry in the diagnosis of leiomyoma is discussed. Surgical excision in this case excluded malignancy, provided a definitive diagnosis of a rare entity and resulted in marked clinical improvement. [ABSTRACT FROM AUTHOR]

Non-Hodgkin’s lymphomas of the orbit and ocular adnexa (OOA), the majority of which are extranodal marginal zone B-cell lymphomas of mucosa-associated lymphoid tissue-type (MALT lymphomas), are a rare disorder. The aim of this study was to evaluate the clinical features and treatment outcomes and complications in patients with MALT lymphoma of OOA. Thirty-seven patients with a histologically verified diagnosis of MALT lymphoma of OOA were included in this retrospective, observational case study. There were 22 (59%) men and 15 (41%) women, with a median age of 44 years (range, 21-80 years). The most common presenting complaint was a slowly growing orbital mass. The stages were IAE in 74%, IAEE (bilateral involvement) in 18%, IIIAE in 6%, and IVAE in 3%. None of the patients had an elevated value of LHD or ß2-microglobulin. Surgical resection alone was attempted as the sole treatment in two patients, but tumor recurred 19 and 24 months after surgery. Radiotherapy, with a median tumor dose of 3,060 cGy, was administered in 29 patients; all of the patients achieved complete remission, and none of them had severe later complications. Combination chemotherapy alone was employed in three patients with stage IIIAE or IVAE. With a median follow-up duration of 21 months, the 3-year overall survival (OS) rate and event-free survival (EFS) rate were 97% and 86%, respectively. Subgroup analysis of the patients with localized disease, who received radiotherapy as an initial treatment modality, revealed that 3-year OS rate and EFS rate were 100% and 93%, respectively. All disease recurrences were documented histologically as MALT lymphoma. In conclusion complete staging evaluation is needed to select an adequate treatment modality. Radiotherapy alone can produce excellent local control and survival in patients with localized MALT lymphoma of OOA. Systemic chemotherapy should be considered in patients with advanced stages or systemic manifestation. [ABSTRACT FROM AUTHOR]

Simple Summary: The treatment of orbital and eyelid B-cell lymphoma remains a field of progress. The aim of our study was to analyze patients diagnosed, staged and treated for orbital and eyelid B-cell lymphoma to assess clinical characteristics, treatment outcomes and recurrence patterns. We included in this study 141 cases of orbital and eyelid B-cell lymphoma. We found five lymphoma subtypes and we confirmed that the histopathologic subtype and the type of treatment were found to be the main factors influencing treatment outcome. Background: The aim of this study was to analyze patients diagnosed, staged and treated for orbital and eyelid B-cell lymphoma (OEL). Methods: One hundred and forty-one cases of OEL were included in this study. Primary endpoints were to analyze the histopathologic findings, the main risk factors and the type of treatment and to correlate them with recurrence of OEL. The secondary endpoint was to determine the progression-free survival (PFS) time. Results: Extranodal marginal zone B-cell lymphoma was the most frequent subtype (66%), followed by small lymphocytic lymphoma (12.7%), diffuse large B-cell lymphoma (DLBCL) (9.2%), follicular lymphoma (6.6%), mantle cell lymphoma (4.3%) and Burkitt lymphoma (1.2%). The probability of relapse was influenced by the histopathologic subtype DLBCL (OR = 7.7, 95% CI 1.8–32.3) and treatment with chemotherapy (OR = 14.9, 95% CI 2.6–83.7). Multivariate analysis showed that the histopathologic subtype DLBCL and chemotherapy treatment retained statistical significance for a poorer PFS, with hazard ratios of 8.581 (p = 0.0112) and 9.239 (p = 0.0094), respectively. Conclusions: Five lymphoma subtypes were found in patients with OEL. The histopathologic subtype and the type of treatment were found to be the main factors influencing treatment outcome. [ABSTRACT FROM AUTHOR]

A 55-year-old Caucasian woman presented with an orbital cavernous haemangioma superior to the optic nerve in the orbital apex. Preoperative imaging demonstrated a mass involving the superomedial and superolateral quadrants of the posterior orbit. A stereotactic fronto-orbital approach was performed by the neurosurgical team, and cryoextraction of the lesion was accomplished by the ocular plastic surgical team. [ABSTRACT FROM AUTHOR]

A case of isolated schwannoma of the orbit, arising from the terminal branches of the abducens nerve to the lateral rectus muscle, is reported. The patient presented with a painless proptosis of the left eye. Preoperative diagnosis of benign intraorbital neoplasm was made by means of CT and MR scans; the mass was radically excised through a microsurgical lateral orbitotomy and the pathological examination revealed a schwannoma. Features of orbital schwannoma are described, together with some details concerning the surgical strategy and the history of the evolution of the lateral orbitotomy. [ABSTRACT FROM AUTHOR]