Orbital tumors

Orbital tumors are abnormal growths of tissue in the structures that surround the eye. These lesions may be either benign or malignant, and may arise primarily from the orbit or may spread (metastasize) from elsewhere in the body. The most common types of orbital tumors vary considerably by age, but include cysts, vascular lesions (arising from blood vessels), lymphomas, neurogenic tumors (arising from nerves), and secondary tumors (either metastatic or spread directly from the surrounding sinuses or cranium).

On occasion, these tumors may be symptom-free, and patients may develop their symptoms slowly over a long period. Other patients have a very rapid onset of symptoms, and the location and nature of their symptoms are often important clues to determine whether a problem is benign or malignant. Many patients develop a bulging of the eye (proptosis or exophthalmos) from the orbit that contains the tumor. Because the eye may be pushed forward, the eyelids often appear to be retracted from it. Some tumors can actually be seen or felt on examination. Some orbital tumors may cause decreased vision, transient episodes of vision loss, or double vision.

Careful examination by a trained physician is critical to the diagnosis of an orbital tumor. This physician can best consider a patient’s symptoms, assess their vision, and check the health of the normal structure and function of the orbital structures. If necessary, additional imaging tests, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), may be used to better evaluate these lesions. Because many of these lesions have characteristic findings on examination and imaging, a biopsy is not always necessary; however, other circumstances may require a biopsy to determine what type of tumor is present.

A variety of treatment options exist for these tumors, and the modality used depends on the type of tumor. Whenever possible, these lesions are removed using careful surgical techniques. However, not all tumors require surgical excision and in some, radiation, chemotherapy, or immunotherapy may be the indicated form of treatment. As a result, we work closely with several other services to ensure the best possible outcomes for our patients, including neurosurgery, otolaryngology, radiation oncology, radiology, plastic surgery, and internal medicine.