Orbital Tumor: Personal Experience

Presented at Asian Oceanian Skull Base Surgery Congress 2006, Dubai, UAE:

 

 

Orbital Tumor

 

Dody Priambada,

 Kanujoso Djatiwibowo Hospital,

Balikpapan,  East Borneo

Indonesia

 

Objective

Orbital cavity is a small area with many structure lies there. The difficulty with the orbital anatomy stems from the highly compact three dimensional space that contains vital neurovascular structures suspended in sea of fat. Muscle, Lymphoid, Vessel, Duramater, Fibrous tissue and the important thing: optic bulb and optic nerve. Exophthalmus, pain, diplopia swelling, tearing, and blurred vision are common presenting symptoms. Although Exophthalmus is a cardinal sign, it is not limited to orbital tumor. The tumor origin could be from the structure it self, metastases, or continuing from intracranial.

Material and Methods

The study report 5 cases of orbital tumor between 2003-2006 in Kanujoso Djatiwibowo Hospital Balikpapan . All patients were exophthalmus. The range of patient age is 38 – 55.  Sex distribution was 1 man and 4 women.  One patient had tumor going into palpebra superior, 1 had intracranial ( meningioma from sphenoid wing), 1 osteoma, and 2 pure intra orbital tumor. For patient with palpebra tumor, combine intra and extra cranial was done.  For the orbital meningioma from sphenoid wing a wide craniotomy combine pterional approach was done, to remove intracranial tumor. A drill was used to open orbital roof and the osteoma.

During remove the tumor, close identification of intra orbital vital neurovascular structure must be done. The tumor is separated carefully and gentle to avoid destruction of the vital neurovascular structure

Result

Resection of tumor was done to remove the tumor.  Beside remove the tumor the cosmetic problem ( exophthalmus ) is an important thing. Although exophltalmus decreases in all patients, it is not totally disappeared. The osteoma is the difficult one because the bone is very hard. The histopathologic results were: the man one has malignant tumor, an adenoid cystic carcinoma, it is from lacrimal gland ; the 3 women are benign meningioma and another woman is osteoma

Conclusion

 Five Orbital tumors have been reported with different origin. One is malignant. The approach is depending on the location, combine is recommended if the tumor lies widely anterior and posterior of the bulb. Close identification and gentle tumor removal is needed to avoid destruction of the vital neurovascular structure

Keywords:

Orbital tumor, neurovascular structure, exophthalmus