[THE KARYOMETRIC AND KARYOCHEMICAL ASPECT OF ANGIOSARCOMAS (ACCORDING TO NEW OBSERVATIONS). PRELIMINARY NOTE].
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Orbital neoplasms and their treatment may have significant negative impact on patient's survival, function, and appearance. It is essential to establish early and accurate diagnosis. The anatomic location of the orbit allows neoplastic processes to threaten structures in the intracranial cavity relatively easily. This adds significantly to the complexity of managing orbital tumors. Improved surgical approaches allow better visualization of the neoplasm and greater protection of essential anatomic structures. This also permits immediate functional and aesthetic reconstruction. A multidisciplinary approach involving the head and neck surgeon, neurosurgeon, reconstructive surgeon, ophthalmologist, radiologist, radiation oncologist, and medical oncologist enhances the quality of management of orbital lesions. Further development of new techniques as well as improved application of adjuvant modalities will, it is hoped, continue to improve the prognosis of patients with orbital neoplasms.
OBJECTIVE: In order to evaluate the relationship between the orbital neoplasms and the resulting visual field damage. METHOD: 22 cases of orbital tumors and tumor-like lesions were examined with automated perimetry. RESULTS: Visual field alterations varied from arcuate, inferior altitudinal, ceeocentral scotomas, to temporal hemianopsia and diffuse defect. The surgical removal of the tumor or steroid administration was followed by partial or full perimetric recovery. CONCLUSIONS: Visual field alteration reflects the severity of the optic nerve damage. The impairment is reversible. Apical masses may cause severe optic neuropathy. Axonal and vascular factors are involved in the main pathological mechanisms of the disease.
Malignant peripheral sheath tumor (malignant PNS tumor) is a rare, aggressive, and lethal orbital neoplasm that usually arises from sensory branches of the trigeminal nerve in adults. Malignant PNS tumor spreads along nerves to involve the brain, and most patients die within 5 years of clinical diagnosis. The clinical history and examination, imaging studies, surgical procedures, and pathologic specimens of a 23-year-old man with rapid, posttraumatic onset of left orbital proptosis and pain are reported. Biopsy specimens of the tumor were compared with specimens from the same orbit obtained 18 years previously. Histopathology of the left orbital tumor compared with that of an incomplete excision of a tumor 18 years previously in the same orbit revealed both to be malignant PNS tumor. The patient is alive without recurrence 8 months after orbital exenteration and 18 years after initial tumor presentation. This is the youngest age of occurrence and the longest documented survival of a patient with orbital malignant PNS tumor.
Orbital pseudotumors are inflammatory lesions of the orbit of unknown etiology, which initially mimic an orbital neoplasm. Involvement of the other orbit is uncommon, and extension into the paranasal sinus rare. Intracranial extension of pseudotumor of the orbit is previously unreported. This is a case report of a patient with pseudotumor of the orbit with intracranial extension. The literature of the subject is reviewed.
This article reviews options in dealing with tumors of the cornea and conjunctiva, nictitating membrane neoplasms, and eyelid neoplasms. Orbital tumors, optic nerve and other intraocular tumors are also discussed.
PURPOSE: Although rare, primary orbital neoplasms are a cause of significant morbidity. For the most part, the proximity of orbital tumors to delicate ocular neural and microvascular structures renders their surgical excision challenging. We investigated the utility of radiofrequency-induced thermal lesions in a rabbit model as potential means of less invasive therapy for benign orbital tumors. METHODS: A small radiofrequency (RF) probe was inserted through the conjunctiva at the fornix and guided along the orbital rim toward the apex of rabbit orbits. The exact location of the probe was ascertained using magnetic resonance (MR) imaging before heating. RF currents at a frequency of 500,000 Hz were conveyed through the exposed tip of a thin RF probe, causing a steady tissue temperature of 90 degrees C for 120 seconds. RESULTS: By using this technology, we induced targeted, localized, and reproducible elliptical thermocoagulative lesions in the rabbit orbit. CONCLUSIONS: We believe this technology has promise as a less invasive alternative or adjunct to open surgical debulking of difficult orbital tumors.
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Radiotherapy has an established place in the treatment of some tumours in children, both for cure and palliation. An evaluation of this form of treatment is made, based on experience with the children admitted to the Christie Hospital and Holt Radium Institute during the past 30 years.
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