Analysis Of Clinicopathological And Imaging In 145 Patients With Orbital Space-occupying Lesions

Objective:to investigate the histopathologic classification and distribution of 145 space-occupying orbital lesions. to study the imaging characteristic and distribution in orbital division of orbital neoplasm. so orbital tumors can be diagnosed correctly before surgery.Methods:a retrospective review of 145 patients with orbital tumor identified by pathological examination at the Affiliated Hospital of Medical College of Qingdao University from April 1,2003 to July 1,2010.Study the distribution of pathology and common tumors in different age groups were determined.the clinical signs and iconographic characterizations of orbital tumors were summarized.According to 4-sector method,145 cases of orbital lesions confirmed by pathology were analyzed on the bases of their distributions.Results:Among 145 patients,141(97.2%) were primary orbital tumors,3(2.1%)were secondary tumors, and 1(0.7%)were metastatic tumors. The most common orbital space-occupying lesions in general category were:vasculogenic,41cases(28.2%);cystic,37 cases(25.5%); lacrimal gland lesions,21cases(14.4%);inflammatory lesions,14(9.6%); lymphomatic lesions, 11cases(7.6%). Among these lesions, were benign and were malignant. The four most common benign lesions were cavernous hemangioma, dermoid cyst, pleomorphic adenoma, orbital inflammation. The four most common malignant lesions were lymphoma, adenocarcinoma, secondary tumors, adenoid cystic carcinoma. In the patients younger than 18-year-old,the most common tumors were: dermoid cyst, 20cases(13.8%), epidermoid cyst,4cases(2.7%), lipoma,4 cases(2.7%). In the 19 to 59-year-old patients, the most common benign tumors were cavernous hemangiomas,33cases(38%);the common malignant tumors were:lymphoma,3 cases(3.4%); adenoid cystic carcinoma,2 cases(1.4%). In the patients older than 60-year-old,the most common benign tumors were cavernous hemangiomas,3cases(11.5%);the common malignant tumors were:lymphoma,8 cases(30.7%);Adenocarcinoma,3 cases(11.5%).Most benign neoplasms show round or oval with clear border and seldom involve other intraorbital structures while malignant neoplasms show irregular mass with unclear margin and extensive infiltration. The tumors in the subconjunctival and extro-periosteum compartment are all benign,The benign tumors in introconal compartment are 33 cases(94.3%), Malignant tumors are 2 cases(5.7%); The benign tumors in extroconal compartment are 46 cases(82.1%), Malignant tumors are 10 cases(17.9%); The benign tumors in mixed type compartment are 7 cases(36.8%), Malignant tumors are 12 cases(63.2%); In addition,The most cavernous hemangiomas are in the introconal compartment;lacrimal gland lesions are located in the extroconal compartment.Conclusion:The kinds of orbital occupication are enormous Cavernous hemangioma is the most common disease in the benign orbital diseases and lymphoma in malignant orbital tumors. Dermoid cyst and epidermoid cyst were the most common causes of orbital space-occupying lesions among the children. Some orbital tumors have characteristic manifestations respectively in iconography. The distributional differences of benign and malignant lesions among introconal, extroconal and mixed type compartment. The age of patients, imaging findings and tumor location provide us important information for preoperative diagnosis of an orbital tumor and for the determination of the treatment strategy.