Orbital Lesions: A Retrospective Review From a Single Institute. (21st September 2018)

• Record Type: Journal Article
• Authors: Salib, Christian; Adem, Patricia; Juechter, Kenneth; Bortz, John; Zhong, Minghao
• Is Part Of: American journal of clinical pathology. Volume 150(2018)Supplement 1
• Page Start: S10
• Page End: S10
• Publication Date: 2018-09-21
• Subjects: Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqy090.023
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: While the spectrum of orbital lesions is broad, the reported incidence of orbital mass lesions varies considerably. Moreover, there are very limited reported data in the current literature regarding orbital lesions, due in part to the rarity of lesions at this anatomical site. Conventionally, these lesions are clinically assessed via computerized tomography (CT), with surgical excision as a therapeutic modality. Here we attempt to assess prevalence of various lesions at this anatomical site. Methods: A retrospective chart review was performed for 425 orbital lesion cases between 2005 and 2017 at our institute. All clinical and pathological information was collected and analyzed. Disease diagnoses were categorized into seven categories (skin, dermal appendages, neural, lymphoma, inflammatory, rare conditions, and other). Results: 1. Of the 425 cases, nearly 29% are malignant cases, of which 50% are lymphomas and 23% are squamous cell carcinomas. 2. A total of 64.3% of all lymphomas were extranodal marginal zone lymphoma (MZL) and only one case (3.6%) was Burkitt lymphoma. 3. A total of 47% of clinically diagnostic cases arose from skin, including epidermal inclusion cysts (25%), xanthogranulomas (2.2%), and seborrheic keratosis (1.1%). 4. Neural lesions showed 58.8% meningiomas, while malignant peripheral nerve sheath tumors comprised 5.9% of cases. 5. Rare entities comprised 5.7% of all cases, including rhabdomyosarcomas, as well as glomangiomas, granular cell tumors, orbital pseudotumors, and metastatic breast carcinomas. Conclusion: This study demonstrates that orbital lesions often present as an array of pathological diagnoses, ranging from benign inflammatory conditions to aggressively malignant entities. The clinical impression of most orbital masses is often consistent with final pathological diagnosis. Nevertheless, the histopathological assessment provides more accurate diagnosis, especially for those rare entities.