Nonmalignant Tumors of the Orbit
Most orbital tumors are nonmalignant. Nonmalignant orbital tumors can arise from any of the structures within the orbit, including blood vessels, fat, nerves, lacrimal gland, and connective tissue. Nonmalignant orbital tumors can be grouped into cystic lesions, vascular tumors, lymphoproliferative lesions, inflammatory lesions, mesenchymal tumors, neurogenic tumors, and lacrimal gland tumors. Although most orbital tumors are benign, their location may compromise ocular health and function and
... cessitate treatment with surgery, radiation, or chemotherapy. Patient characteristics, signs, and findings on ophthalmic examination and imaging, including computed tomography and magnetic resonance imaging, guide the clinician in formulating a differential diagnosis. Presentation Orbital tumors often present with a constellation of signs suggestive of a spaceoccupying lesion in the bony confines of the orbit. These orbital signs include lid edema or fullness; ptosis or retraction; proptosis or nonaxial globe displacement; axial hyperopia or acquired astigmatism; vascular or lymphatic congestion producing conjunctival chemosis; hyperemia or secondary glaucoma; dysmotility or palsy of cranial nerve II, III, IV, V, or VI; chorioretinal folds; optic nerve edema or atrophy; and double vision or loss of vision. In addition to a complete ophthalmic examination, appropriate imaging, including ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI), provides valuable information regarding the location and radiographic characteristics of the lesion. Often the patient's age, sex, race, clinical course, and radiographic images can narrow the differential diagnosis. Incisional or excisional biopsy may be pursued to confirm the diagnosis.