2. INTRODUCTION
• ORBIT: many vital
structures and tissues
• Confined space : visually
significant symptoms-
irreversible vision loss
• Neoplastic/
inflammatory/infectious
3. Origin of tumors
• Arise primarily within the
orbit or secondarily from
an adjacent source, such as
the eyelid, paranasal sinus,
or intracranial
compartment.
• Orbital tumors can also be
metastatic from distant
sites.
4. Etiology :Primary orbital tumors can be
classified according to the tissue of origin
Cystic Tumors
• Epidermoid cyst
• Dermoid cyst
• Mucocele
• Hematic pseudocyst
• Meningoencephalocele
• Apocrine hidrocystoma
• Colobomatous cyst
11. Dermoid cyst
• C/F: More common in children
• Subcutaneous mass near orbital
rim; firm, fixed, painless
• Most often superotemporal or
superonasal rim, corresponding
to bony sutures
• R/F: well circumscribed cystic
lesion
12. Mucocele/mucopyocele
• Symptoms of chronic
rhinosinusitis
• R/F: depends on the
contents of mucocele
• Adjacent sinus
opacification with bony
erosion
14. Congenital bilateral frontoethmoidal
meningoencephalocele
• <1% of all orbital tumors
• Congenital in children or acquired after craniofacial trauma
• Anterior mass: fluctuant, smooth swelling near the medial canthus
• Posterior mass: pulsating proptosis, strabismus
15. Apocrine
hidrocystoma
• C/F: Common lid lesions rarely
grow within the orbit
• Presentation varies depending on
the location of the mass
• R/F: Thin-walled, well-
circumscribed cystic mass
16. Cavernous hemangioma/ cavernous
venous malformation
• Most common benign orbital
tumor
• 2nd-4th decades
• 60% of patients are female
• Accelerated growth during
pregnancy
• Painless, progressive proptosis
•Well-circumscribed intra- or extra-conal mass
•Contrast-enhanced imaging early stippled pattern with late
homogeneous enhancement
17. Orbital lymphangioma
•0.3 to 4% of
all orbital
tumors
•1st-2nd
decade of
life; affects
men and
women
equally
•Progressive
mass effect
•Proptosis
does
not worsen
with Valsalva
•Multiple
loculations
with air-fluid
levels
18.
19. Capillary
hemangioma :
• Most common benign orbital tumor in children
• 3% of all orbital tumors
• Variable presentation depending on location
20. Capillary hemangiomas of the orbit, also known as strawberry
hemangiomas, on account of its coloring, or orbital infantile
the most common orbital tumors of infancy,
Differential considerations include:
•other vascular malformations of the orbit
• cavernous hemangioma of the orbit
• orbital venous varix
• orbital lymphangioma
•orbital tumors
• retinoblastoma
• orbital metastases
• rhabdomyosarcoma
• chloroma
21. Neurofibroma orbit
• C/F:2 to 4% of orbital tumors
• Plexiform: 1st decade, almost always associated with NF1
• Localized: 3rd-5th decade
• Progressive proptosis, EOM restriction, ptosis, optic neuropathy
• R/F: Smooth ovoid lesions with variable contrast enhancement
22. Optic nerve sheath meningioma
• 2% of all orbital tumors
• 4th-5th decade of life
• Women 3x more likely affected
• Gradual painless vision loss, optic atrophy; optociliary shunt vessels
• Smooth, tubular, enhanced with calcifications
• "Tram tracking" sign (axial) or "doughnut" sign (coronal) on MRI
23.
24. Sphenoid wing meningiomas
• NF2 patients
• 2.5x more common
in females
• Proptosis, vision
loss, temporal
fullness, ptosis,
restricted EOMs
25. Giant cell granuloma
• benign fibro-osseous proliferation
• Most common : jaw
• Rarely in orbit
• Potentially aggressive and destructive
• Most often in women of 2nd decade
26. Fibrous
dysplasia orbit
• Monostotic form: 2nd to
3rd decade
• Polyostotic form:
childhood,seen in
McCune Albright
syndrome
• "Pagetoid" pattern of
radiolucent and
radiopaque areas on CT
27. Dermolipomas
and lipomas
• These benign lesions may have deep extensions
that can extend to the levator aponeurosis and
extraocular muscles. Superficially, dermolipomas
may have fine hairs that can be irritating to
patients
28. Benign reactive
lymphoid
hyperplasia
• Predilection for male gender
• Often in superior orbit
• Heterogenous, low
attenuation on CT; conform
to the shape of the globe
• Follicles composed of
reactive lymphocyte
proliferation
