Neoplasms of the Orbit

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Questions and Answers

A surgeon is planning the removal of an orbital tumor. Which type of tumor would offer the most predictable dissection due to its well-defined borders?

  • Cavernous hemangioma
  • Pleomorphic adenoma (correct)
  • Capillary hemangioma
  • Lymphangioma

A 6-year-old child presents with a suspected orbital tumor. Imaging reveals an unencapsulated mass. Which vascular tumor is most likely?

  • Neurilemmoma
  • Metastatic tumor
  • Capillary hemangioma (correct)
  • Cavernous hemangioma

An adult patient is diagnosed with a benign orbital tumor. The tumor is encapsulated. Which of the following is most likely?

  • Non-Hodgkin lymphoma
  • Capillary hemangioma
  • Lymphangioma
  • Cavernous hemangioma (correct)

Non-Hodgkin lymphoma affecting the orbit is classified according to which system?

<p>World Health Organization (WHO) (A)</p> Signup and view all the answers

A patient with prostate carcinoma develops orbital symptoms. How might this metastatic tumor present?

<p>Mimicking idiopathic orbital inflammation. (C)</p> Signup and view all the answers

Periorbital ecchymoses in a child might suggest metastasis of which tumor?

<p>Neuroblastoma (A)</p> Signup and view all the answers

Which of the following orbital tumors is NOT typically encapsulated?

<p>Lymphangioma (C)</p> Signup and view all the answers

If a primary orbital malignancy arises from the lacrimal gland, how is it typically classified?

<p>Similar to salivary gland tumors (C)</p> Signup and view all the answers

Which characteristic makes encapsulated orbital tumors surgically important?

<p>Their predictable dissection during surgery (B)</p> Signup and view all the answers

A pathologist identifies neoplastic cells in an orbital biopsy. The cells are determined to be of lymphatic origin. Which diagnosis is most likely?

<p>Lymphoma (A)</p> Signup and view all the answers

A 45-year-old patient presents with gradually increasing proptosis and diplopia. Imaging reveals a well-defined, encapsulated mass in the orbit. Which vascular tumor is most likely?

<p>Cavernous hemangioma (D)</p> Signup and view all the answers

A child presents with sudden periorbital ecchymoses after a minor trauma. Further examination reveals an orbital mass. Which of the following metastatic tumors should be suspected?

<p>Wilms tumor (D)</p> Signup and view all the answers

Which orbital malignancy is classified using a system similar to that used for salivary gland tumors?

<p>Lacrimal gland tumor (A)</p> Signup and view all the answers

An adult patient presents with unilateral proptosis and a palpable mass in the lacrimal gland region. Which encapsulated tumor should be included in the differential diagnosis?

<p>Pleomorphic adenoma (B)</p> Signup and view all the answers

A patient is diagnosed with Non-Hodgkin Lymphoma (NHL) affecting the orbit. What is a typical characteristic that can be observed?

<p>It can affect either the entire orbit or specific compartments. (C)</p> Signup and view all the answers

A 70-year-old male presents with new-onset orbital inflammation that is unresponsive to typical treatments. Imaging reveals a mass in the orbit. Which metastatic tumor should be highly suspected?

<p>Prostate carcinoma (B)</p> Signup and view all the answers

In a child presenting with periorbital ecchymoses, which imaging modality would be most helpful in differentiating between a vascular tumor and metastatic neuroblastoma or Wilms tumor?

<p>CT scan with contrast (A)</p> Signup and view all the answers

Which aspect of cavernous hemangiomas makes them preferable for surgical removal, compared to lymphangiomas?

<p>Their encapsulated nature (D)</p> Signup and view all the answers

In the classification of primary orbital malignancies, what is the significance of determining the parent tissue of origin?

<p>It dictates the classification system used (e.g., salivary gland tumors for lacrimal gland tumors). (D)</p> Signup and view all the answers

A patient presents with gradual proptosis, diplopia, and a palpable orbital mass. The mass appears to be well circumscribed on imaging. Which of the following should be prioritized in the differential diagnosis?

<p>Encapsulated tumors (B)</p> Signup and view all the answers

Flashcards

Capillary Hemangioma

Most common primary orbital tumors, often unencapsulated in infancy/childhood.

Lymphangioma

Unencapsulated vascular tumors of the orbit.

Cavernous Hemangioma

Encapsulated vascular tumors typically found in adults.

Encapsulated Tumors

Tumors with a defined boundary, making surgical removal more predictable.

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Pleomorphic Adenoma

A benign mixed tumor, commonly found in the lacrimal gland.

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Dermoid Cyst

A benign growth containing skin appendages. It is an example of an encapsulated orbital tumor.

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Neurilemmoma

A tumor arising from the nerve sheath, also known as a schwannoma. It is an example of an encapsulated orbital tumor.

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Non-Hodgkin Lymphoma (NHL)

A type of cancer affecting lymphoid tissue that can involve the entire orbit or specific compartments. Classified per WHO lymphoma classification.

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Primary Orbital Malignancies

Malignant tumors originating from any of the tissues within the orbit.

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Metastatic Tumors

Tumors that have spread to the orbit from a primary cancer site elsewhere in the body.

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Neuroblastoma/Wilms Tumor

Periorbital ecchymoses (bruising around the eye) may indicate this type of metastatic tumor.

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Study Notes

  • Neoplasms of the orbit include vascular tumors, encapsulated tumors, lymphoma, primary orbital malignancies, and metastatic tumors.

Vascular Tumors

  • These are the most common primary orbital tumors.
  • Types include capillary hemangioma, lymphangioma, and cavernous hemangioma.
  • Capillary hemangiomas typically occur in infancy or childhood and are unencapsulated.
  • Lymphangiomas are also unencapsulated.
  • Cavernous hemangiomas usually occur in adults and are encapsulated.

Encapsulated Tumors

  • Encapsulation is surgically important due to predictable dissection.
  • Examples include:
    • Pleomorphic adenoma (lacrimal gland)
    • Dermoid cyst
    • Neurilemmoma

Lymphoma

  • Non-Hodgkin lymphoma (NHL) can affect the entire orbit or specific compartments (e.g., lacrimal gland).
  • Classified per the WHO lymphoma classification.

Primary Orbital Malignancies

  • Can arise from any orbital tissue.
  • Classification is based on the parent tissue.
  • Lacrimal gland tumors are classified like salivary gland tumors.

Metastatic Tumors

  • These tumors may have unique signs and symptoms.
  • Prostate carcinoma can mimic idiopathic orbital inflammation.
  • Neuroblastoma and Wilms tumor may cause periorbital ecchymoses due to vascularity.
  • Metastatic tumors may invade from adjacent sinuses.

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