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Orbital Mass


Presentation

  • To present the case of an 8-month-old girl with undiagnosed pre-B-cell acute lymphoblastic leukemia (ALL) presenting as an orbital mass. Observational case report and literature review.[ncbi.nlm.nih.gov]
  • Orbital infection with nontuberculous mycobacteria is rare and usually presents as an inflammatory process.[ncbi.nlm.nih.gov]
  • To report a case of renal cell carcinoma presenting as a well-circumscribed orbital tumor. Retrospective interventional case report. A 60-year-old woman presented with proptosis of the left eye.[ncbi.nlm.nih.gov]
  • We describe a case of intravascular lymphoma that presented as an orbital mass lesion. A 77-year-old female presented with longstanding fatigue and one-month of diplopia.[ncbi.nlm.nih.gov]
  • Presentation with proptosis secondary to orbital mass in childhood acute lymphoblastic leukemia (ALL) is very rare.[ncbi.nlm.nih.gov]
Cervical Lymphadenopathy
  • A computed tomographic scan of the orbits revealed a homogeneous, retrobulbar orbital mass eroding into the ethmoid sinuses and nasal cavity, as well as cervical lymphadenopathy.[ncbi.nlm.nih.gov]
Soft Tissue Mass
  • We report a child with pre-B cell ALL with an extramedullary soft tissue mass involving both orbits presenting with proptosis, and give a brief overview of the literature about this unusual entity.[ncbi.nlm.nih.gov]
  • He was found to have left-sided proptosis, and imaging studies showed a large left medial orbital soft-tissue mass. Incisional biopsy revealed adenoid cystic carcinoma. Further evaluation revealed extensive sinonasal adenoid cystic carcinoma.[ncbi.nlm.nih.gov]
  • MRI revealed an enhancing infiltrative soft tissue mass in the inferior aspect of the right orbit and biopsy of the mass demonstrated non-necrotizing granulomas. Chest CT scan was normal and PET scan showed no other organ involvement.[ncbi.nlm.nih.gov]
  • Palpate the orbital rim, soft tissues, masses (note location, shape and size). Check for a globe pulsation or thrill (with the bell of the stethoscope over the closed eye). Check eye movements.[patient.info]
Lymphadenopathy
  • A diagnosis of sarcoidosis was rendered and on further clinical work-up, she was detected to have hilar lymphadenopathy.[ncbi.nlm.nih.gov]
  • A computed tomographic scan of the orbits revealed a homogeneous, retrobulbar orbital mass eroding into the ethmoid sinuses and nasal cavity, as well as cervical lymphadenopathy.[ncbi.nlm.nih.gov]
  • Additional clinical and radiologic workups showed multiple lytic bone lesions, diffuse lymphadenopathy, a pelvic mass, multiple mesenteric soft tissue nodules, and multiple pulmonary nodules, although none of the aforementioned sites was biopsied.[ncbi.nlm.nih.gov]
Asymptomatic
  • We describe a rare case of asymptomatic sarcoidosis with orbital mass as the presenting feature in a young woman. The lesion was excised with the clinical possibility of a thrombosed varix.[ncbi.nlm.nih.gov]
Constitutional Symptom
  • RESULTS: No difference was found between the two groups in relation to WG type (limited and systemic forms), ethnicity, laboratory features, constitutional symptoms or clinical manifestations, including upper respiratory tract, and treatment, except for[ncbi.nlm.nih.gov]
Weight Loss
  • He also had systemic symptoms of fatigue and weight loss. An examination revealed hepatosplenomegaly and lymph node enlargement. Investigations showed a peripheral smear with blast cells, which were also revealed through a bone marrow biopsy.[ncbi.nlm.nih.gov]
Aspiration
  • Fine-needle aspiration biopsy was performed with 22-25-gauge needles and use of the freehand technique.[ncbi.nlm.nih.gov]
  • Fine-needle aspiration of the mass was performed. Numerous foreign body giant cells were seen which contained polarizable filamentous material. A diagnosis of foreign body granuloma was rendered which was confirmed on histopathology.[ncbi.nlm.nih.gov]
  • The CT findings were compared and correlated with the findings of fine needle aspiration cytology (FNAC) or histopathology.[ncbi.nlm.nih.gov]
  • AIM: To assess the diagnostic value of the orbital fine needle aspiration biopsy (FNAB) with an in vitro technique, eliminating the sampling error. DESIGN: Prospective, non-randomised, interventional case series.[ncbi.nlm.nih.gov]
  • Once discovered and imaged with MRI/ CT, the next step in the management of orbital tumors is diagnosis of the type of tumor either with an open biopsy or a fine needle aspiration biopsy (FNAB).[skullbaseinstitute.com]
Saddle Nose
  • OBJECTIVES: The relationship between saddle nose deformity (SND) in Wegener's granulomatosis (WG) and other clinical features, including retro-orbital mass formation (ROM), has been poor described.[ncbi.nlm.nih.gov]
Rhinorrhea
  • An 8-month-old girl presented with a 2-week history of right-sided tearing, lid swelling, proptosis, and rhinorrhea.[ncbi.nlm.nih.gov]
Vomiting
  • Anaesthetic management was highlighted by the presence of preoperative signs and symptoms of increased intraocular pressure--somnolence, nausea and vomiting, and bradycardia. These signs and symptoms were alleviated postoperatively.[ncbi.nlm.nih.gov]
  • The pain had no positional features, and there was no accompanying photophobia, nausea, vomiting, sensitivity to noise, weakness, numbness, or tingling; the pain tended not to occur in the . . .[nejm.org]
Pelvic Mass
  • Additional clinical and radiologic workups showed multiple lytic bone lesions, diffuse lymphadenopathy, a pelvic mass, multiple mesenteric soft tissue nodules, and multiple pulmonary nodules, although none of the aforementioned sites was biopsied.[ncbi.nlm.nih.gov]
Hepatosplenomegaly
  • An examination revealed hepatosplenomegaly and lymph node enlargement. Investigations showed a peripheral smear with blast cells, which were also revealed through a bone marrow biopsy.[ncbi.nlm.nih.gov]
Thrombosis
  • Upon disappearance of the lesion, the authors reviewed the case thoroughly and decided that orbital venous anomaly with intralesional hemorrhage/thrombosis was the most probable diagnosis.[ncbi.nlm.nih.gov]
Diplopia
  • We report a case of a 34-year-old male hospital worker with a positive purified protein derivative skin test who had Mycobacterium fortuitum infection that presented as an orbital mass causing diplopia.[ncbi.nlm.nih.gov]
  • A 77-year-old female presented with longstanding fatigue and one-month of diplopia. Magnetic resonance imaging (MRI) revealed a frontal lobe brain lesion and a right orbital mass. Brain biopsy was interpreted as anaplastic oligodendroglioma.[ncbi.nlm.nih.gov]
  • Eleven months later he complained of progressive diplopia, which was found on computed tomography to be caused by a retro-orbital metastatic mass. There was no evidence of a space occupying lesion in the brain or of other metastases.[ncbi.nlm.nih.gov]
  • Acute worsening of proptosis leading to corneal abrasion, diplopia, and pain required debulking surgery, for which an orbitozygomatic approach was utilized. Genetic testing for NF-1 revealed no mutation.[ncbi.nlm.nih.gov]
  • We report a case of orbital sarcoidosis in a 66 year old male who presented with one month history of right eye swelling and intermittent diplopia.[ncbi.nlm.nih.gov]
Unilateral Proptosis
  • A 48-year-old woman with a history of chronic intranasal cocaine abuse presented with unilateral proptosis associated with severe visual loss from optic neuropathy in the right eye.[ncbi.nlm.nih.gov]
  • We present the case of a 52-year-old male with progressive, marked unilateral proptosis due to a multilobulated orbital mass, secondary to biopsy-proven plexiform neurofibroma (PN).[ncbi.nlm.nih.gov]
  • Symptoms Orbital tumors typically present with early unilateral proptosis of the globe and may adversely affect visual and extraocular muscle function. Other symptoms include double vision (diplopia), and pupillary abnormalities.[skullbaseinstitute.com]
  • Vision may be blurred. [ 4 ] Look for a (usually unilateral) proptosis, severe conjunctival oedema (chemosis) and limited eye movement caused by a combination of cranial nerve palsy and physical limitation of movement.[patient.info]
Strabismus
  • Our team of doctors includes leading experts in ophthalmic plastic surgery, endoscopic orbital surgery, strabismus, thyroid gland disorders, neurosurgery, and head and neck oncology.[masseyeandear.org]
Epistaxis
  • We present a case of aspergillus sinusitis complicated by intractable epistaxis after debridement of the nasal septum, which caused pain and rapid distension of the nasolacrimal sac.[ncbi.nlm.nih.gov]
Somnolence
  • CLINICAL FEATURES: A four year old child presented to hospital with orbital swelling of recent onset, nausea and somnolence. Computed tomography and brain scan demonstrated a normal brain with a mass in the left orbit.[ncbi.nlm.nih.gov]
Cranial Neuropathy
  • A case of myeloid sarcoma presenting with an orbital mass, hearing loss, and multiple cranial neuropathies. Turk J Pediatr 2018; 60: 322-325.[ncbi.nlm.nih.gov]

Workup

  • Additional clinical and radiologic workups showed multiple lytic bone lesions, diffuse lymphadenopathy, a pelvic mass, multiple mesenteric soft tissue nodules, and multiple pulmonary nodules, although none of the aforementioned sites was biopsied.[ncbi.nlm.nih.gov]
  • He did not improve with this more aggressive therapy and was transferred to UIHC for further workup and management.[webeye.ophth.uiowa.edu]
Multiple Pulmonary Nodules
  • Additional clinical and radiologic workups showed multiple lytic bone lesions, diffuse lymphadenopathy, a pelvic mass, multiple mesenteric soft tissue nodules, and multiple pulmonary nodules, although none of the aforementioned sites was biopsied.[ncbi.nlm.nih.gov]
Multiple Lytic Bone Lesions
  • Additional clinical and radiologic workups showed multiple lytic bone lesions, diffuse lymphadenopathy, a pelvic mass, multiple mesenteric soft tissue nodules, and multiple pulmonary nodules, although none of the aforementioned sites was biopsied.[ncbi.nlm.nih.gov]
Mycobacterium Fortuitum
  • We report a case of a 34-year-old male hospital worker with a positive purified protein derivative skin test who had Mycobacterium fortuitum infection that presented as an orbital mass causing diplopia.[ncbi.nlm.nih.gov]

Treatment

  • Since early diagnosis and aggressive treatment of orbital involvement could lead to better prognosis, the presence of SND warrants additional vigilance.[ncbi.nlm.nih.gov]
  • Irradiation was selected for treatment of the lesion on the basis of the radiological diagnosis; subsequently, the lesion gradually reduced in size.[ncbi.nlm.nih.gov]
  • After embolization of the maxillary artery to control the epistaxis, the nasolacrimal sac hematoma spontaneously resolved, and the patient proceeded with his medical treatment without the need for orbital surgery.[ncbi.nlm.nih.gov]
  • This rare case of NF-negative orbital PN and multidisciplinary treatment considerations for expansile orbital tumors are discussed.[ncbi.nlm.nih.gov]
  • Rapid investigation and timely initiation of treatment are needed to salvage the eye and the vision. Orbital involvement is considered to confer a poorer prognosis to children with ALL.[ncbi.nlm.nih.gov]

Prognosis

  • Orbital involvement is considered to confer a poorer prognosis to children with ALL.[ncbi.nlm.nih.gov]
  • Since early diagnosis and aggressive treatment of orbital involvement could lead to better prognosis, the presence of SND warrants additional vigilance.[ncbi.nlm.nih.gov]
  • Prognosis Surgical removal is curative for many orbital tumors and the cosmetic results can be excellent. The outcome and prognosis ultimately depends on the pathological diagnosis.[skullbaseinstitute.com]
  • Melanoma Malignant tumor often detected when small size so prognosis is usually favorable. Nevus Benign tumor that classically remains stable. Can lead to reduced visual acuity. Can transform into melanoma.[isoo.org]
  • Prognosis is very poor. Metastases : In children the orbit may be the site of secondary deposits from neuroblastoma or acute leukaemia.[patient.info]

Etiology

  • In conclusion, the possible etiologies of orbital masses are numerous, and arriving at the correct imaging and clinical diagnosis can be challenging as a result.[cureus.com]
  • The initial presentation of acute onset proptosis with optic nerve compromise can be suggestive of infectious etiologies, however, this case suggests caution in evaluation of patients with known systemic malignancy, particularly ALL, as early intervention[ncbi.nlm.nih.gov]
  • Diagnosis Evaluation of a patient with a presumed orbital mass begins with a thorough ophthalmic and medical history including history of allergies, sinus infections, recent trauma to rule out all non-neoplastic sinonasal etiologies for the disease process.It[skullbaseinstitute.com]

Epidemiology

  • EPIDEMIOLOGY Disease of childhood Peak age of incidence between 1 and 4 years of age Has been reported in adults SIGNS Proptosis Periorbital erythema and swelling CT demonstrating classic osteolytic lesion SYMPTOMS Localized tenderness Proptosis TREATMENT[webeye.ophth.uiowa.edu]
Sex distribution
Age distribution

Prevention

  • However, a working familiarity of the expected imaging appearance of common orbital masses can greatly inform the appropriate subsequent management of the patient and help prevent unnecessary procedures.[cureus.com]
  • Can they be prevented? As they are many kinds of tumors, the production mechanism for each one of them is different. But in eyelid tumors, the risk factor is sun damage.[icrcat.com]

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