This document discusses extraconal orbital tumors. It describes the extraconal space and some of its contents like nerves, vessels, and lacrimal gland. Common extraconal orbital lesions are then outlined, including dermoid cysts/tumors, lacrimal gland tumors, hemangiomas, lymphangiomas, and rhabdomyosarcoma. Specific tumor types like dermoids, pleomorphic adenoma of the lacrimal gland, adenoid cystic carcinoma, capillary hemangioma, and rhabdomyosarcoma are then described in more detail, covering clinical presentation, imaging, pathology, management, and prognosis.
The document discusses various orbital tumors categorized by their location within the orbit. Retinoblastoma and malignant uveal melanoma occur in the globe. Optic nerve glioma and optic nerve sheath meningioma originate in the optic nerve sheath complex. Cavernous hemangioma is the most common tumor found in the intraconal compartment. Dermoids are typically located extraconally. Benign mixed tumor and adenoid cystic carcinoma can arise from the lacrimal gland. Rhabdomyosarcoma occurs in the extraconal compartment. Lymphoma and fibrous dysplasia involve the bone and sinus compartment. Imaging plays an important role in the diagnosis and staging of these orbital tumors.
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
The document discusses several pathologies that can cause proptosis (forward displacement) of the eye including orbital pseudotumor, Graves' ophthalmopathy, optic neuritis, and lymphoproliferative lesions of the orbit. Orbital pseudotumor is a non-granulomatous inflammatory process that can involve any orbital structure. Graves' ophthalmopathy is associated with thyroid dysfunction and causes enlargement of the extraocular muscles. Optic neuritis typically causes enlargement and enhancement of the optic nerve. Lymphoproliferative lesions include benign lymphoid hyperplasia and lymphomas, appearing as enhancing masses or infiltrative lesions.
This document discusses the anatomy and common mass lesions of the orbit. It begins with an overview of orbital anatomy, describing the structures within the intraconal and extraconal spaces. Common orbital mass lesions are then reviewed, including those arising within the globe like retinoblastoma and melanoma, as well as lesions in the intraconal, extraconal, and orbital wall spaces. Specific details are provided on the incidence, clinical and radiographic features, and differential diagnosis of retinoblastoma and melanoma. Other globally arising lesions like choroidal detachment are also mentioned.
Presentation1.pptx, radiological imaging of cerebello pontine angle mass lesi...Abdellah Nazeer
This document describes the anatomy of the cerebellopontine angle and summarizes various pathologies that can present as masses in this region as seen on radiological imaging. It discusses solid masses like schwannomas and meningiomas, cystic masses like arachnoid cysts and epidermoid cysts, lipomatous masses, vascular lesions, and other less common pathologies that can secondarily involve the cerebellopontine angle. For each type of lesion, it provides examples of imaging findings and characteristic features on MRI.
This document summarizes various orbital and intracranial pathologies that can cause vision loss or eye abnormalities. It describes conditions such as ruptured globe, retinal detachment, choroidal detachment, optic neuritis, thyroid orbitopathy, retinoblastoma, optic pathway glioma, and pituitary macroadenomas, among others. Diagnostic imaging findings are provided for many conditions. Orbital cellulitis and inflammatory diseases are distinguished. The document also outlines anatomical details of certain cranial nerves that are susceptible to compression or injury.
This document discusses pediatric orbital tumors and tumor-like lesions. It focuses on rhabdomyosarcoma and hemangioma. Rhabdomyosarcoma is the most common orbital malignancy in children, typically manifesting as rapidly progressive proptosis. Imaging can help diagnose and stage it, with CT showing bone involvement and MRI detecting soft tissue extension. Hemangioma is also common, usually appearing in infancy as a reddish macule that enlarges over months. Imaging demonstrates its lobular contour and intense enhancement, helping differentiate it from other lesions.
The document provides details on the anatomy of the orbit including its borders, contents, neurovascular structures, and surgical approaches. It describes the bones that form the borders of the orbit, as well as the contents such as the eyeball, muscles, nerves, vessels, and fatty tissue. Various surgical approaches for orbital tumors are summarized, including extracranial and transcranial methods, as well as endoscopic endonasal approaches.
The document discusses various orbital tumors categorized by their location within the orbit. Retinoblastoma and malignant uveal melanoma occur in the globe. Optic nerve glioma and optic nerve sheath meningioma originate in the optic nerve sheath complex. Cavernous hemangioma is the most common tumor found in the intraconal compartment. Dermoids are typically located extraconally. Benign mixed tumor and adenoid cystic carcinoma can arise from the lacrimal gland. Rhabdomyosarcoma occurs in the extraconal compartment. Lymphoma and fibrous dysplasia involve the bone and sinus compartment. Imaging plays an important role in the diagnosis and staging of these orbital tumors.
The document discusses various types of orbital tumours and pathologies. It describes three main intraorbital spaces - intraconal, conal and extraconal - and examples of pathologies that can occur in each space. It provides details on orbital lymphoma, rhabdomyosarcoma, orbital metastasis and dermoid cysts. For each condition, it outlines clinical features, location in the orbit, radiological features on CT and MRI such as signal characteristics, enhancement patterns and appearance. Common primary cancers that metastasize to the orbit are also listed.
The document discusses several pathologies that can cause proptosis (forward displacement) of the eye including orbital pseudotumor, Graves' ophthalmopathy, optic neuritis, and lymphoproliferative lesions of the orbit. Orbital pseudotumor is a non-granulomatous inflammatory process that can involve any orbital structure. Graves' ophthalmopathy is associated with thyroid dysfunction and causes enlargement of the extraocular muscles. Optic neuritis typically causes enlargement and enhancement of the optic nerve. Lymphoproliferative lesions include benign lymphoid hyperplasia and lymphomas, appearing as enhancing masses or infiltrative lesions.
This document discusses the anatomy and common mass lesions of the orbit. It begins with an overview of orbital anatomy, describing the structures within the intraconal and extraconal spaces. Common orbital mass lesions are then reviewed, including those arising within the globe like retinoblastoma and melanoma, as well as lesions in the intraconal, extraconal, and orbital wall spaces. Specific details are provided on the incidence, clinical and radiographic features, and differential diagnosis of retinoblastoma and melanoma. Other globally arising lesions like choroidal detachment are also mentioned.
Presentation1.pptx, radiological imaging of cerebello pontine angle mass lesi...Abdellah Nazeer
This document describes the anatomy of the cerebellopontine angle and summarizes various pathologies that can present as masses in this region as seen on radiological imaging. It discusses solid masses like schwannomas and meningiomas, cystic masses like arachnoid cysts and epidermoid cysts, lipomatous masses, vascular lesions, and other less common pathologies that can secondarily involve the cerebellopontine angle. For each type of lesion, it provides examples of imaging findings and characteristic features on MRI.
This document summarizes various orbital and intracranial pathologies that can cause vision loss or eye abnormalities. It describes conditions such as ruptured globe, retinal detachment, choroidal detachment, optic neuritis, thyroid orbitopathy, retinoblastoma, optic pathway glioma, and pituitary macroadenomas, among others. Diagnostic imaging findings are provided for many conditions. Orbital cellulitis and inflammatory diseases are distinguished. The document also outlines anatomical details of certain cranial nerves that are susceptible to compression or injury.
This document discusses pediatric orbital tumors and tumor-like lesions. It focuses on rhabdomyosarcoma and hemangioma. Rhabdomyosarcoma is the most common orbital malignancy in children, typically manifesting as rapidly progressive proptosis. Imaging can help diagnose and stage it, with CT showing bone involvement and MRI detecting soft tissue extension. Hemangioma is also common, usually appearing in infancy as a reddish macule that enlarges over months. Imaging demonstrates its lobular contour and intense enhancement, helping differentiate it from other lesions.
The document provides details on the anatomy of the orbit including its borders, contents, neurovascular structures, and surgical approaches. It describes the bones that form the borders of the orbit, as well as the contents such as the eyeball, muscles, nerves, vessels, and fatty tissue. Various surgical approaches for orbital tumors are summarized, including extracranial and transcranial methods, as well as endoscopic endonasal approaches.
Presentation1.pptx, radiological imaging of spinal cord tumour.Abdellah Nazeer
This document discusses the radiological imaging and classification of spinal cord tumors. It describes how spinal cord tumors are classified as extra-dural, intra-dural extra-medullary, or intra-medullary. Common benign extra-dural tumors discussed include hemangioma, osteoid osteoma, osteochondroma, eosinophilic granuloma, and epidural lipomatosis. Imaging findings for diagnosing these tumors with x-ray, CT, and MRI are provided. Malignant primary tumors of the spine discussed include chordoma, lymphoma, osteosarcoma, and chondrosarcoma. Metastatic tumors to the spine are also mentioned.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
The document provides information on imaging of the orbit. It discusses orbital anatomy including the bony orbit and passages. It then covers various imaging modalities used for the orbit such as radiography, ultrasound, CT, MRI, angiography and their applications. Finally, it discusses common orbital lesions that can be imaged such as inflammatory lesions, tumors, vascular lesions, and infections. Imaging plays an important role in evaluating the numerous pathologies that can affect the confined space of the orbit.
Sellar, Suprasellar and Pineal tumor final pk .pptDr pradeep Kumar
this is very good presentation slide for radiologist and radiology resident. our references is authentic and most are from osborn brain imaging 2nd edition. This deal with sellar, suprasellar and pineal tumor . This help alot. thanks
This document discusses optic pathway gliomas and hypothalamic gliomas. It begins by defining optic pathway gliomas as tumors confined to the precortical visual pathway, sometimes involving the hypothalamus. Their location makes them surgically challenging to manage, and the optimal management is controversial. The document then covers the epidemiology, pathology, clinical presentation, imaging, differential diagnosis, natural history, and management options for these tumors, which include observation, surgery, chemotherapy and radiotherapy. Management depends on factors like age, presence of NF1, tumor location and size, and symptoms.
Presentation2, radiological imaging of neck schwannoma.Abdellah Nazeer
A 32-year-old female presented with a left facial nerve schwannoma. Imaging showed a bilobed hyperintense mass in the left parotid and mastoid regions on T2-weighted imaging, connected by an interconnecting stalk along the vertical segment of the facial nerve. There was restricted diffusion seen within the peripheral rim of the tissue. Schwannomas are benign nerve sheath tumors that commonly occur in the head and neck region, arising from the cranial nerves. They appear as well-defined masses that are iso- to hyperintense on T1- and T2-weighted MRI relative to muscle. Characteristic features include identification of the nerve of origin and restricted diffusion.
Presentation1, radiological imaging of cavernous sinus lesions.Abdellah Nazeer
This document discusses radiological imaging of lesions in the cavernous sinus. It begins with an overview of cavernous sinus anatomy and venous drainage. Common tumors and lesions that can involve the cavernous sinus are then described, including pituitary adenomas, meningiomas, schwannomas, metastases, and vascular lesions such as aneurysms and carotid-cavernous fistulas. For each type of lesion, key imaging features on CT and MRI are provided.
The document discusses various orbital and peri-orbital tumours. It describes lymphomas as characterized by subacute proptosis, lid swelling and diplopia. Rhabdomyosarcoma is outlined as the most common orbital malignancy in children, often presenting as sudden, rapidly progressive proptosis. Basal cell carcinoma is discussed as the most common lid neoplasm, with potential for local spread but no metastasis.
This document summarizes various pathologies that can present as pineal region masses. It describes signs and symptoms such as Parinaud syndrome, hydrocephalus, precocious puberty, and pineal apoplexy. It then discusses tumors of pineal parenchymal origin including pineocytoma, pineal parenchymal tumor of intermediate differentiation, and pineoblastoma. It also covers germ cell tumors, pineal cysts, astrocytoma, and meningioma that can occur in the pineal region. Imaging findings for each condition are provided with examples.
This document provides an overview of various demyelinating diseases of the central nervous system. It begins by defining demyelinating diseases as those involving disruption of myelin, which forms an insulating sheath around axons. It then classifies and describes several specific diseases, including acute disseminated encephalomyelitis (ADEM), inflammatory demyelinating pseudotumor, multiple sclerosis (MS), neuromyelitis optica, central pontine myelinolysis, HIV encephalopathy, progressive multifocal leukoencephalopathy (PML), and others. For each disease, it discusses clinical features, magnetic resonance imaging (MRI) findings, differential diagnoses, and pathology where relevant.
This document provides an overview of orbital anatomy and diseases. It describes the major anatomic components of the orbit including the globe, optic nerve, extraconal and intraconal areas. Common pathologies are discussed for each anatomic structure, such as retinoblastoma affecting the globe and optic neuritis involving the optic nerve. Imaging techniques for evaluating the orbit including MRI and CT are also reviewed. Key anatomical structures like the superior orbital fissure and its contents are defined.
1) The document discusses intrinsic and extrinsic pineal region masses, focusing on benign cysts, germ cell tumors, and teratomas.
2) Benign cysts are common incidental findings that appear fluid-like on MRI but may enhance along the rim. Germinomas are the most common pineal germ cell tumor, appearing solid with homogeneous enhancement.
3) Teratomas contain fat, calcium, and mixed signal components due to varying tissue types, and demonstrate little enhancement post-contrast. Differential diagnosis and radiologic features of common pineal region lesions are provided.
The document summarizes different types of vascular lesions of the orbit. It describes capillary hemangiomas as the most common orbital vascular tumor in infants, appearing at or after birth and slowly involuting over years. Cavernous malformations are more common in adults and present with progressive, painless proptosis. Orbital varices typically manifest in young adults and often occur with intracranial venous anomalies, distending during maneuvers that increase venous pressure or presenting with thrombosis/hemorrhage. Imaging helps characterize the lesions and rule out complications.
1. The document discusses orbital tumors in adults, including the anatomy of the orbit and its contents.
2. Common adult orbital tumors include vascular tumors like cavernous hemangioma, neural tumors such as optic nerve sheath meningioma, lymphoma, and lacrimal gland tumors including pleomorphic adenoma and carcinoma.
3. Metastatic tumors to the orbit from other primary cancers are less common than metastases to the choroid. The most common presenting signs of orbital tumors are proptosis, optic disc edema, and loss of vision.
Presentation2, radiological imaging of phakomatosis.Abdellah Nazeer
Von Hippel-Lindau disease is characterized by the development of numerous benign and malignant tumors in different organs due to mutations in the VHL tumor suppressor gene. Common manifestations include renal cell carcinomas, renal cysts, pheochromocytomas, pancreatic cysts and tumors, retinal hemangioblastomas, and cerebellar hemangioblastomas. Patients may develop tumors in the kidneys, pancreas, liver, adrenal glands, and brain. The variety of lesions that can occur has led to the mnemonic "HIPPEL" to remember the key features of VHL disease.
This document summarizes various pathologies that can affect the eye and orbit. It discusses congenital anomalies, infections and inflammations, tumors, trauma, and miscellaneous conditions. For each condition, it provides a brief description and highlights relevant imaging findings on modalities such as CT, MRI, and plain films. Key features that help characterize many lesions include enhancement patterns, involvement of surrounding structures, and presence of calcification.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness and availability. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
1. The document discusses various MRI sequences used in neuroradiology including T1, T2, FLAIR, PD, DWI, GRE, MRS and perfusion.
2. It provides detailed information on the appearance of common intracranial pathologies on T1 and T2 sequences, such as hemorrhage, tumors, infections and more.
3. Examples of brain images are shown to illustrate the characteristic appearances of lesions including hemorrhage, tumors, infarcts and other abnormalities on different MRI sequences.
Dr. Usman Haqqani presented on craniopharyngioma, a rare benign tumor that behaves malignantly. It most commonly occurs in children and presents a bimodal age distribution. On imaging, craniopharyngiomas often show calcification and can be classified based on location, consistency, and histology. Surgical resection is the primary treatment but the approach depends on tumor anatomy and location. Post-operatively, patients require monitoring and management of complications such as diabetes insipidus, hormone deficiencies, and obesity. Long term follow up involves imaging and endocrine evaluations.
This document discusses the surgical management of sphenoid wing meningiomas. It covers the anatomy, classification, clinical presentation, diagnosis using CT, MRI and angiography, surgical treatment approaches including pterional, alar/middle, and clinoidal craniotomies, reconstruction after resection, potential complications, and results. The goal of surgery is radical resection of the tumor along with the dural implant and any hyperostotic bone to reduce the risk of recurrence.
Presentation1.pptx, radiological imaging of spinal cord tumour.Abdellah Nazeer
This document discusses the radiological imaging and classification of spinal cord tumors. It describes how spinal cord tumors are classified as extra-dural, intra-dural extra-medullary, or intra-medullary. Common benign extra-dural tumors discussed include hemangioma, osteoid osteoma, osteochondroma, eosinophilic granuloma, and epidural lipomatosis. Imaging findings for diagnosing these tumors with x-ray, CT, and MRI are provided. Malignant primary tumors of the spine discussed include chordoma, lymphoma, osteosarcoma, and chondrosarcoma. Metastatic tumors to the spine are also mentioned.
This document provides an overview of cerebellopontine angle masses, including their incidence, location, and radiographic features. It discusses the most common masses such as vestibular schwannoma (acoustic neuroma), CPA meningioma, and epidermoid cyst. For each type of mass, it describes their typical appearance on CT and MRI scans, including signal characteristics and enhancement patterns. It also provides differential diagnoses to help distinguish between different pathologies that can present in the CPA region. The goal is to help readers learn as much as possible about CPA masses to aid in successful diagnosis and management.
The document provides information on imaging of the orbit. It discusses orbital anatomy including the bony orbit and passages. It then covers various imaging modalities used for the orbit such as radiography, ultrasound, CT, MRI, angiography and their applications. Finally, it discusses common orbital lesions that can be imaged such as inflammatory lesions, tumors, vascular lesions, and infections. Imaging plays an important role in evaluating the numerous pathologies that can affect the confined space of the orbit.
Sellar, Suprasellar and Pineal tumor final pk .pptDr pradeep Kumar
this is very good presentation slide for radiologist and radiology resident. our references is authentic and most are from osborn brain imaging 2nd edition. This deal with sellar, suprasellar and pineal tumor . This help alot. thanks
This document discusses optic pathway gliomas and hypothalamic gliomas. It begins by defining optic pathway gliomas as tumors confined to the precortical visual pathway, sometimes involving the hypothalamus. Their location makes them surgically challenging to manage, and the optimal management is controversial. The document then covers the epidemiology, pathology, clinical presentation, imaging, differential diagnosis, natural history, and management options for these tumors, which include observation, surgery, chemotherapy and radiotherapy. Management depends on factors like age, presence of NF1, tumor location and size, and symptoms.
Presentation2, radiological imaging of neck schwannoma.Abdellah Nazeer
A 32-year-old female presented with a left facial nerve schwannoma. Imaging showed a bilobed hyperintense mass in the left parotid and mastoid regions on T2-weighted imaging, connected by an interconnecting stalk along the vertical segment of the facial nerve. There was restricted diffusion seen within the peripheral rim of the tissue. Schwannomas are benign nerve sheath tumors that commonly occur in the head and neck region, arising from the cranial nerves. They appear as well-defined masses that are iso- to hyperintense on T1- and T2-weighted MRI relative to muscle. Characteristic features include identification of the nerve of origin and restricted diffusion.
Presentation1, radiological imaging of cavernous sinus lesions.Abdellah Nazeer
This document discusses radiological imaging of lesions in the cavernous sinus. It begins with an overview of cavernous sinus anatomy and venous drainage. Common tumors and lesions that can involve the cavernous sinus are then described, including pituitary adenomas, meningiomas, schwannomas, metastases, and vascular lesions such as aneurysms and carotid-cavernous fistulas. For each type of lesion, key imaging features on CT and MRI are provided.
The document discusses various orbital and peri-orbital tumours. It describes lymphomas as characterized by subacute proptosis, lid swelling and diplopia. Rhabdomyosarcoma is outlined as the most common orbital malignancy in children, often presenting as sudden, rapidly progressive proptosis. Basal cell carcinoma is discussed as the most common lid neoplasm, with potential for local spread but no metastasis.
This document summarizes various pathologies that can present as pineal region masses. It describes signs and symptoms such as Parinaud syndrome, hydrocephalus, precocious puberty, and pineal apoplexy. It then discusses tumors of pineal parenchymal origin including pineocytoma, pineal parenchymal tumor of intermediate differentiation, and pineoblastoma. It also covers germ cell tumors, pineal cysts, astrocytoma, and meningioma that can occur in the pineal region. Imaging findings for each condition are provided with examples.
This document provides an overview of various demyelinating diseases of the central nervous system. It begins by defining demyelinating diseases as those involving disruption of myelin, which forms an insulating sheath around axons. It then classifies and describes several specific diseases, including acute disseminated encephalomyelitis (ADEM), inflammatory demyelinating pseudotumor, multiple sclerosis (MS), neuromyelitis optica, central pontine myelinolysis, HIV encephalopathy, progressive multifocal leukoencephalopathy (PML), and others. For each disease, it discusses clinical features, magnetic resonance imaging (MRI) findings, differential diagnoses, and pathology where relevant.
This document provides an overview of orbital anatomy and diseases. It describes the major anatomic components of the orbit including the globe, optic nerve, extraconal and intraconal areas. Common pathologies are discussed for each anatomic structure, such as retinoblastoma affecting the globe and optic neuritis involving the optic nerve. Imaging techniques for evaluating the orbit including MRI and CT are also reviewed. Key anatomical structures like the superior orbital fissure and its contents are defined.
1) The document discusses intrinsic and extrinsic pineal region masses, focusing on benign cysts, germ cell tumors, and teratomas.
2) Benign cysts are common incidental findings that appear fluid-like on MRI but may enhance along the rim. Germinomas are the most common pineal germ cell tumor, appearing solid with homogeneous enhancement.
3) Teratomas contain fat, calcium, and mixed signal components due to varying tissue types, and demonstrate little enhancement post-contrast. Differential diagnosis and radiologic features of common pineal region lesions are provided.
The document summarizes different types of vascular lesions of the orbit. It describes capillary hemangiomas as the most common orbital vascular tumor in infants, appearing at or after birth and slowly involuting over years. Cavernous malformations are more common in adults and present with progressive, painless proptosis. Orbital varices typically manifest in young adults and often occur with intracranial venous anomalies, distending during maneuvers that increase venous pressure or presenting with thrombosis/hemorrhage. Imaging helps characterize the lesions and rule out complications.
1. The document discusses orbital tumors in adults, including the anatomy of the orbit and its contents.
2. Common adult orbital tumors include vascular tumors like cavernous hemangioma, neural tumors such as optic nerve sheath meningioma, lymphoma, and lacrimal gland tumors including pleomorphic adenoma and carcinoma.
3. Metastatic tumors to the orbit from other primary cancers are less common than metastases to the choroid. The most common presenting signs of orbital tumors are proptosis, optic disc edema, and loss of vision.
Presentation2, radiological imaging of phakomatosis.Abdellah Nazeer
Von Hippel-Lindau disease is characterized by the development of numerous benign and malignant tumors in different organs due to mutations in the VHL tumor suppressor gene. Common manifestations include renal cell carcinomas, renal cysts, pheochromocytomas, pancreatic cysts and tumors, retinal hemangioblastomas, and cerebellar hemangioblastomas. Patients may develop tumors in the kidneys, pancreas, liver, adrenal glands, and brain. The variety of lesions that can occur has led to the mnemonic "HIPPEL" to remember the key features of VHL disease.
This document summarizes various pathologies that can affect the eye and orbit. It discusses congenital anomalies, infections and inflammations, tumors, trauma, and miscellaneous conditions. For each condition, it provides a brief description and highlights relevant imaging findings on modalities such as CT, MRI, and plain films. Key features that help characterize many lesions include enhancement patterns, involvement of surrounding structures, and presence of calcification.
This document provides recommendations for imaging the orbit and eye. It discusses ultrasound, CT, and MR as modalities for evaluating intraocular lesions and complex orbital structures. Ultrasound is recommended as the first-line modality due its non-invasiveness and availability. CT provides excellent evaluation of bone structures and detection of calcifications. MR offers superior soft tissue contrast for evaluating orbital and intracranial structures. Imaging protocols for CT and MR of the orbit and eye are outlined, including recommended sequences, planes of imaging, and use of contrast. Anatomical diagrams illustrate orbital bones and structures visible on different imaging views.
1. The document discusses various MRI sequences used in neuroradiology including T1, T2, FLAIR, PD, DWI, GRE, MRS and perfusion.
2. It provides detailed information on the appearance of common intracranial pathologies on T1 and T2 sequences, such as hemorrhage, tumors, infections and more.
3. Examples of brain images are shown to illustrate the characteristic appearances of lesions including hemorrhage, tumors, infarcts and other abnormalities on different MRI sequences.
Dr. Usman Haqqani presented on craniopharyngioma, a rare benign tumor that behaves malignantly. It most commonly occurs in children and presents a bimodal age distribution. On imaging, craniopharyngiomas often show calcification and can be classified based on location, consistency, and histology. Surgical resection is the primary treatment but the approach depends on tumor anatomy and location. Post-operatively, patients require monitoring and management of complications such as diabetes insipidus, hormone deficiencies, and obesity. Long term follow up involves imaging and endocrine evaluations.
This document discusses the surgical management of sphenoid wing meningiomas. It covers the anatomy, classification, clinical presentation, diagnosis using CT, MRI and angiography, surgical treatment approaches including pterional, alar/middle, and clinoidal craniotomies, reconstruction after resection, potential complications, and results. The goal of surgery is radical resection of the tumor along with the dural implant and any hyperostotic bone to reduce the risk of recurrence.
The parapharyngeal space is a potential space located in the neck that contains important structures like the carotid artery and cranial nerves. Tumors in this space can be benign or malignant, with the most common types being salivary gland tumors in the prestyloid space and neurogenic tumors in the retrostyloid space. Imaging like CT and MRI are used to determine the location and characteristics of the tumor. Surgical excision is typically the primary treatment, with the surgical approach depending on factors like size and involvement of surrounding structures. Observation or radiation therapy may be options for certain patients who cannot undergo surgery.
This document describes a case of neuroblastoma in a 16-month-old boy presenting with fever, poor appetite, and abdominal distension. Imaging including ultrasound, CT, and MRI revealed a large heterogeneous mass arising from the left adrenal gland, compressing local structures. Biopsy showed poorly differentiated neuroblastoma. Treatment and prognosis depend on risk stratification based on age, stage, biology. High-risk disease requires intensive chemotherapy with stem cell transplant while low-risk cases may only require surgery or observation.
retroperitoneal mass and retroperitoneal anatomyLeena Anjali
1. A large retroperitoneal mass with involvement of nearby vessels and necrosis suggests leiomyosarcoma. Neurofibromas and schwannomas show a target sign on MRI, while malignant fibrohistiocytoma, synovial sarcoma, and Ewing's sarcoma appear as a "bowl of fruit sign".
2. Lymphoma appears as an infiltrative, hypovascular mass around the aorta and vena cava without compression. Paraganglioma presents in young patients with high blood pressure and urine vanillylmandelic acid, appearing hypervascular on imaging.
3. Retroperitoneal liposarcomas are classified based on appearance, with well-different
A complete unit of the various diseases involving the orbit and the surrounding structures. It involves the unilateral and bilateral proptosis conditions. Also, the various proptosis etiologies involved in adults and children along with various tumors involving the orbit is also dealt with.
Abstract
Carotid body tumors are rare, slow-growing, hypervascular neuroendocrine tumors. Although these tumors are benign neoplasm, they also have a tendency to malignant transformation. Complete surgical excision is the gold standard therapeutic modality for the treatment of carotid body tumors. Early surgical removal is recommended to prevent the development of larger and more advanced tumors, which are associated with higher morbidity and mortality. In this report, we presented three cases of carotid body tumor which were successfully treated with complete surgical excision, and reviewed the current literature. Furthermore, it was emphasized the necessity of early surgical management regardless of patient age and tumor size.
Imaging gives a clue on pattern recognition for differential diagnosis. Therefore imaging alone may not be sufficient for the diagnosis of MM.
Hematopathologic and Histopathologic correlation are important key for differentiation and definitive diagnosis.
anatomy of orbital spaces, tumours and its importanceShashank Agarwal
1. The document summarizes the anatomy of the orbital spaces and their clinical importance. It describes the four main anatomical spaces in the orbit - subperiosteal, peripheral orbital, central, and sub-Tenon's space.
2. The spaces are important because benign tumors typically remain within their space of origin, while large, malignant, or infiltrative tumors can spread beyond their original space. Understanding the orbital anatomy helps determine the surgical approach for orbitotomy or local anesthesia techniques.
3. Common pathologies are described for each space, such as dermoid cysts in the subperiosteal space and cavernous hemangiomas in the central space. Imaging features and clinical presentations of select conditions are
Three key points about imaging the orbit:
1. CT scans provide the best view of bony details and calcifications in the orbit, and can detect small fractures and foreign bodies. Slice thickness and tissue windows must be optimized for diagnostic quality.
2. Different x-ray views (like Waters, Caldwell's, and lateral) allow visualization of specific orbital structures and are useful for identifying pathology in different areas.
3. Features seen on imaging like changes in bone density, orbital size and shape, and structures like the optic canal can indicate conditions like tumors, infections, fractures, and vascular abnormalities affecting the orbit. Precise imaging analysis is important for diagnosis.
1. Bone tumors require a thorough evaluation including history, physical exam, imaging, biopsy, and staging to determine the appropriate treatment.
2. Key tests involve x-rays, MRI, CT scans, and biopsy to determine the tumor type and stage.
3. Treatment options depend on the tumor but may include chemotherapy, surgery such as limb salvage surgery or amputation, and reconstruction techniques like prosthetics or bone grafts.
1. Spinal tuberculosis commonly affects the thoracic and lumbar spine in young adults. It can cause neurological deficits through mechanisms such as inflammatory edema, extradural masses, and meningeal involvement.
2. Diagnosis is based on imaging findings on X-ray, CT, or MRI showing bone destruction and abscesses. Treatment involves chemotherapy and sometimes surgery to debride tissue, drain abscesses, or correct deformities.
3. Complications of spinal tuberculosis include paraplegia, cold abscesses, spinal deformities, and recurrence which may require longer treatment or surgical intervention.
This document provides information on the anatomy and functions of various parts of the brain stem, cerebellum, and cerebrospinal fluid. It then discusses low grade gliomas, including diffuse astrocytomas and oligodendrogliomas. For low grade gliomas, the document covers classification, symptoms, diagnostic workup, imaging, molecular markers, management including the roles of surgery, radiotherapy, and chemotherapy, as well as prognostic factors. Complete resection of low grade gliomas often leads to cure, while radiotherapy may help for incompletely resected tumors. Molecular markers like IDH and 1p19q status provide prognostic information.
Spleen; Imaging Anatomy, Investigations and PathologyAli Aboelsouad
This document provides an overview of spleen imaging anatomy, investigations, and pathology. It discusses the gross anatomy and blood supply of the spleen. Common imaging investigations include plain radiography, ultrasound, CT, and MRI. The document describes normal spleen appearances on different modalities and how they are used to detect various congenital anomalies, masses like cysts, hemangiomas, and lymphomas, infiltrative diseases, and other conditions like splenic infarction. Percutaneous biopsy techniques for the spleen are also reviewed.
This presenation includes anatomy and pathology of intraconal conal and extraconal orbital pathology. this presenation dealsimaging feature of different pathology. Thanks.
1) The document discusses various pathologies that can affect the clivus region, including congenital malformations, acquired conditions, and primary and secondary neoplasms.
2) Examples of discussed pathologies include proatlas segmentation failure, neuroenteric cysts, basilar invagination, fibrous dysplasia, chordoma, plasmacytoma, and meningioma.
3) The pathologies are described in terms of their etiology, clinical presentation, diagnostic evaluation, and treatment options.
This document provides information on presacral tumors:
- Presacral tumors can arise from any germ cell layer and have varied etiologies including congenital and neurogenic tumors.
- Imaging such as MRI is important for evaluating the tumor extent and involvement of nearby structures. Biopsy may be needed prior to surgery.
- Complete surgical resection is often challenging due to the tumors' location near the sacrum and involvement of nearby nerves and vessels. A multidisciplinary team is typically involved in the surgical planning and approach.
- Posterior, anterior, and combined approaches can be used depending on the tumor location and extent. Nearby structures like the sacrum or rectum may need resection.
- Long
This document provides information on intracranial tumours, including:
1. Gliomas are the most common primary brain tumour, with astrocytomas being the most common type. They are graded based on malignancy from Grade I to IV.
2. Meningiomas arise from the arachnoids and attach to the dura, comprising 18% of primary brain tumours. They are usually benign but can invade bone.
3. Clinical features of brain tumours include headaches, seizures, neurological deficits depending on the tumour location. Investigations include imaging scans and biopsies while treatments involve surgery, radiation, chemotherapy.
This document discusses the anatomy, pathology, imaging characteristics, differential diagnosis, and surgical approaches related to the cerebellopontine angle. Key points include:
- The cerebellopontine angle contains 3 neurovascular complexes supplied by the superior, anterior inferior, and posterior inferior cerebellar arteries.
- Common pathologies include vestibular schwannomas, meningiomas, and epidermoids. Vestibular schwannomas are the most common tumor.
- Surgical approaches aim to remove the tumor while preserving hearing and facial nerve function. The retrosigmoid approach is most common but transpetrosal approaches are used for large tumors.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Assessment and Planning in Educational technology.pptxKavitha Krishnan
In an education system, it is understood that assessment is only for the students, but on the other hand, the Assessment of teachers is also an important aspect of the education system that ensures teachers are providing high-quality instruction to students. The assessment process can be used to provide feedback and support for professional development, to inform decisions about teacher retention or promotion, or to evaluate teacher effectiveness for accountability purposes.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
2. EXTRACONAL SPACE
• It is the space within the orbit , outside the
musculofascial cone.
• Base – anteriorly , by orbital septum
• External side- by bones of the orbit and their
periosteum
• Internal side- by extraocular muscles and their
fascia
6. EXTRACONAL ORBITAL LESIONS
• From structures within the space:
-Dermid cysts/tumors
-Lacrimal gland tumors
-Capillary hemangioma
-Lymphangioma
- Rhabdomyosarcoma
-Plexiform neurofibroma
-Orbital pseudotumor
-Cavernous hemangioma
-Langerhans histiocytosis (<1% )
-Lymphoma/leukemia
-Orbital Leiomyoma
7. Cont.
• Lesions extending from adjacent structures
into the space:
-metastasis
-sinonasal tumors
*squamous cell carcinoma
*olfactory neuroblastoma
*lymphoma
*adenocarcinoma
*adenoid cystic carcinoma
8. DERMOID TUMORS
• it originates from aberrant ectodermal tissue
• Most common site – temporal zygomatic
suture line on the lateral orbital wall
• Lined by keratinized squamous epithelium
with adnexal structure (hair follicles ,
sebaceous glands)
• Young children are more affected , M:F=1:1
9. • Clinical presentation –
-proptosis (displace orbital structures)
-motility abnormalities and diplopia (pressing
on extraocular muscles)
- vision problems (due to compression of
optic nerve)
• Management – surgical resection / avoid
rupture
13. Pleomorphic adenoma of lacrimal glands
• Benign epithelial neoplasia of the lacrimal gland
• Occurs mostly in 2nd – 5th decade , M:F=1:1
• Clinical presentation –
-palpable superotemporal mass
-proptosis
-down and inward displacement of globe
-S-shaped contour the lid
- restricted upgaze
• Pt. complains of diplopia , reduced visual acuity ,
redness , watering and pain.
14. Cont.
• Fundus examination shows globe indentation in
half of the patients
• Histopathology –
-epithelial components derived from ducts , with
spindle muscle layer.
-presence of microscopic nodular extensions into
the pseudocapsule.
-may undergo squamous metaplasia
15. Cont .
• Imaging-
1. best seen on CT scan , showing pressure indentation
with expansion of lacrimal fossa
-well circumscribed tumor with nodular configuration
and pseudocapsule , calcification may be present
2. on B-scan – highly reflective pseudocapsule , cystic
spaces and well demarcated mass
3. On MRI – smooth well demarcated mass with fossa
formation
- T2 – weighted images are heterogenous
and isointense
16.
17. Management and prognosis
• Complete extripation via a modified lateral
orbitotomy without capsule rupture
• Removal of a margin or adjacent tissue , excision of
the periorbita , preservation of the uninvolved
palpebral lobe.
• Two factors to prevent recurrence –
1. Careful surgical excision without capsular rupture
2. Pre-op diagnosis without incisional biopsy
(incase biopsy is done then involved periorbita ,
adjacent tissue and tract are removed with the
tumor)
18. Adenoid cystic carcinoma of lacrimal gland
• Most common malignant epithelial tumor
• In any age group , F>M
• Bimodal - 2nd and 4th decade , peak incidence in 4th decade of
life
• Clinical presentation –
-frontotemporal mass
-proptosis
-globe displacement
-ptosis
-pain
-parasthesia
-decreased vision
19. Cont.
• Pathology –
-Grossly , grayish white firm , pseudoencapsulated
- Histopathologically – 5 types
*cribriform (glandular/swiss cheese)- most common
*solid (basaloid) – least common , most aggressive
*tubular (ductal)
*sclerosing
*comedocarcinomatous
-infilteration is mostly to bones
20. Cont.
• Imaging –
- Important feature – evidence of lytic (irregular) change
to adjacent bone
- On CT scan – intrinsic lesion is well defined , solid and
homogenous , almond shaped mass
- On MRI – involvent of cavernous sinus , perineural
tissue
- T1-weighted images show diffuse enhancement and
T2-weighted images isointense to brain and extraocular
muscles
21.
22. Management
• Well defined tumors - local excision along with
adjacent bone followed by brachytherapy or
radical external beam therapy
• For tumor extending to bones and soft tissue of
orbit – radical en bloc orbitectomy
- excision of orbital roof , lateral wall and
anterior portion of temporalis muscle is done
- reconstruction involve a myocutaneous
flap for radical radiotherapy
• Distant metastasis is usually to lungs
23. Capillary Haemangioma
• Infantile haemangioma
• A true neoplasm with vascular channels lined by
proliferating endothelial cells
• Common in infancy
• Clinical features –
- Proptosis
- Subtle pulsations can be seen
- Enlarge on valsalva maneuver or crying
- Blue-violet discoloration of lids and conjunctiva
- Refractive errors like myopia and astigmatism
- Amblyopia and strabismus can develop.
24. Imaging
• MRI is the preferred choice –
-lobular contour borders
-bright T2 signal
-intense, homogenous enhancement , fat
deposition
-preservation of adjacent bone
• On B-scan – smooth/irregular contour with high
echogenicity
• Blood flow is demonstrated on doppler
echography
25.
26. Management
• Mostly they regress
• Radiotherapy (radon seed implantation or external
beam therapy) , systemic and local steroids.
• Systemic dosage is 1.5mg/kg to 2.5 mg/kg prednisone
daily for a few weeks with titration downwards.
• Local injection of 40-80 mg triamcinolone with 25 mg
methylprednisolone is given directly into the lesion
• In very large platelet consuming lesions , systemic
antifibrinolytic agents are used.
• In non responsive cases ,controlled resection can be
performed with constant haemostasis
28. Imaging
• On CT – bony abnormalities , enlargement of
orbit
- Venous or solid components of tumor are super
dense
• On MRI – venous component typically enhance ,
lymphatic component only shows fine
enhancement of septations and
macrolobulations
29.
30. Management
• Orbital surgery either on urgent basis if the
hemorrhage is causing optic nerve
compression or on elective basis for chronic
compression
• Circumferential panorbitotomy may be done
to excise much of the offending lesions
31. Rhabdomysarcoma
• Most common childhood soft tissue sarcoma ,
10% in orbit
• 70% occur in 1st decade , orbital
rhabdomysarcoma mean age is 7-8 years
• Bimodal peak with embryonal and alveolar
types. Anaplastic variety is rare.
• Mostly familial – positive family history of
malignancy , Li-Fraumeni syndrome , mutation
of TSG p53.
- congenital malformations and hereditary
retinoblastoma have been seen.
32. Clinical presentation
• Primary can occur from conjunctiva , iris , ciliary
body or extension of primary orbital
rhabdomyosarcoma.
• Secondary occurs fro direct extension to orbits from
surrounding structures
• Orbital metastasis can occur from head and neck
rhabdomyosarcoma , poor prognosis
• Orbital locations –
-extraconal (37%)
-intraconal (17%)
-both (47%)
33. • Presenting complaints
-unilateral proptosis
-globe displacement
-ptosis
-conjunctival and eyelid swelling
-palpable mass
-pain in few cases
34. Pathology
• 3 broad morphological categories:
-embryonal (80%) – classical pattern
-alveloar
-anaplastic/undifferentitated
• Rhabdomyoblasts have cross striations with abundant
eosinophilic cytoplasm having spindle, tadpole or
racquet shaped cells
• On histochemistry – stain with Masson trichome ,
periodic acid schiff (PAS) and phosphotungstic acid-
hematoxylin(PTAH) for acidophilia
- Immunoperoxidase for desmin in tumor
• Alveolar and anaplastic subtype have poor prognosis
35. Imaging
• On CT scan – homogenous , well defined soft
tissue masses without bone destruction
- focal areas of necrosis or hemorrhage can be
seen
• On MRI – T-1 weighted images are isointense
or hypointense to brain
-T-2 weighted images are hyperintense
38. Group number Criteria
I Localised disease, completely resected
A. confined to the organ or muscle of origin
B. infiltration outside organ or muscle of origin;
regional lymph nodes not involved
II Compromised or regional resection of three types including:
A .Grossly resected tumors with microscopic residual
B .Regional disease, completely resected, in which
lymph nodes may be involved and/or extension of
tumor into an adjacent organ may be present
C. Regional disease with involved lymph nodes,
macroscopically resected but with
evidence of microscopic residual
III Incomplete resection or biopsy with macroscopic residual
disease
IV Distant metastases present at onset
39. Management
• In complete resection of tumour – chemotherapy
alone
• In groups II , III , IV – radiation of 4500-5000 cGy
over 4-5 weeks
• Intracranial spread – whole cranial irradiation and
intrathecal chemotherapy
• Good prognosis for group I , II , III
• Poor prognosis for group IV
• Recurrences occur within 3 years and are treated by
chemotherapy with local or radical excision of
tumor
40. Complications of treatment
• 90% develop cataract after radiotherapy
• Other sequelae –
-keratoconjuctivitis
-dry eye
-radiation retinopathy
-lacrimal duct stenosis
-facial asymmetry
-growth retardation due to pitutary hypoplasia
41. Orbital leiomyoma
• Benign tumour arising from the smooth muscle cells
• Rare tumour of the orbit
• Presents in first two decades with no sex predisposition
• Clinically presents as painless proptosis or
displacement of the globe progressing slowly over
several months or years
• Histological features :
-spindle shaped cells arranged in whorls
-"cigar shaped" nuclei
-cytoplasmic eosinophilia
-myogenic filaments stain with Masson’s trichome
42. • Vascular smooth muscle cells in the orbit are currently
believed to be responsible for the histogenesis of this tumor
• The tumor is best diagnosed on CT scan which demonstrates
a well-defined, round to oval circumscribed mass with
moderate contrast enhancement
• Treatment – complete tumor excision as the tumor is not
radiosensitive
- a ring of surrounding tissue should be removed due to multiple
lobulations of the tumor
- Incase subtotal tumor excision is made then the pt is called
for serial neuroimaging studies for signs of recurrence
• D/D - Neurofibroma, fibrous histiocytoma, schwannoma and
amelanotic melanoma
43.
44. Lymphomas
1. B-Cell lymphoma –
-lesions composed of ‘small’ B-cells .
-low grade lymphoma of mucosal associated
lymphoid tissue(MALT) is most common
-On histology diffuse, nodular and germinal
centres
-On Immunology - CD 5 - , CD 10 - , CD 20+ , CD 23-
/+ ,
CD 43 -/+
-Mantle cell lymphomas are more aggressive and
require therapeutic intervention
45. Clinical presentation –
• Seen in 6th- 7th decade of life , in the anterior orbit
• Subconjuctival tumefaction of typical salmon flesh
appearance , which tries to mould the globe
• In lacrimal glands , lymphoepithelial lesions of the
ducts
• Globe displacement
• Mild proptosis
• Secondary orbital and adnexal involvement is seen
46. • On CT scan – well defined , homogenous and
extraconal , lobulated / nodular
- lacrimal gland invovlement is common
-mainly involve soft tissue and seldom
extraocular muscles
• On MRI – TI weighted images – isodense to
hyperintense to extraocular muscles , hypodense
to orbital fat
- T2 weighted images – hyperintense to both fat
and muscles
47. Treatment
• Overall management by a multidisciplinary
team
• Localised orbital lesions – local radiotherapy
(3000 to 3500 cGy)
• Widespread disease - chemotherapeutic
intervention
• Prognosis depends on the age of the pt. ,
tumour systemic spread and histological grade
• Prognosis is generally excellent
48. Other B cell lymphomas
2. Diffuse large B – Cell lymphoma –
-aggressive , intermediate or high-risk orbital lymphoma
-orbital involvement arising in the paranasal sinuses is common
-consists of diffuse sheets of large neoplastic lymphoid cells
3. Burkitt’s Lymphoma – outgrowth of B-cells from germinal
centres , intermediate sized lymphocytes with basophilic
cytoplasm and multiple small nuclei.
-”starry- sky pattern” of phagcytic histiocytes
-13-16% presents with exophthalmos
-chemotherapy with cyclophosphamide , methotrexate etc
gives good prognosis.
49. • Very rarely orbit may develop secondary
lesions from the extraorbital sites of T cell
lymphoma
50. Leukemia
• Soft tissue involvement of the orbit is more
frequent and sudden in acute (esp. lymphoblastic)
rather than in chronic leukemia.
• In childhood malignancies of the orbit , acute
leukemia and granulocytic sarcoma are a frequent
cause of unilateral proptosis (11%)
• Bilaterality is seen in 2% of pts with orbital
leukemia.
• Local irradiation and both intrathecal and systemic
chemotherapy may significantly prolong survival.
51. Orbital metastases
• Average survival is approximately 9 months from
the time of orbital presentation , where the
primary cancer has occurred 31 months before
• Breast cancer has of a delay 3 yrs , thyroid – 5 yrs
between the primary and orbital presentation
• Lung cancer , melanoma and GI tumors have an
early orbital presentation(3.6 average) n poor
prognosis
• RCC and metastatic carcinoid – slow growing ,
solitary orbital metastasis
52. Clinical presentation
• Mass – axial /non axial displacement of globe
• Infiltrative- diplopia , enophthalmos , limitations of eye
movement (frozen globe) , firm orbit
• Functional – decrease in 2nd , 3rd , 4th , 5th , 6th nerve function ,
out of proportional to mass or infilteration
• Inflammatory – pain , chemosis , injection , erythema , lid
swelling
• Silent - no s/s , discovered accidentally on CT/MRI
orbit/Enucealtion of eye
-Motility disturbance out of proportion to the degree of
proptosis can occur and is characteristic of orbital metastasis
53. Syndromes of presentation
• Syndrome of mass (66%) – most common
• 2nd most common is infiltrative presentation ,
eg in metastatic breast cancer (scrrihous) , GI ,
prostate , lung and other primary tumours
• Least common presentation – inflammatory
and functional . Seen in small tight places-
orbital canal / apex
54. Diagnosis and treatment
• Complete history and clinical examination should be
done
• Specific and non specific laboratory tests eg. CEA
• Radioimaging should be done
• Needle biopsy is the best application if suspecting
metastatic tumors
• Proper immunohistochemistry of the sample taken
-although life expectancy is less in orbital metastases
-various treatment modalities can be undertaken to
increase life expectancy in the form of radiotherapy ,
chemotherapy hormonal therapy and surgery
55. Sinonasal carcinoma
• Rare , highly aggressive , cliniopathologically
distinct .
• It is locally invasive often invading to skull base.
• Arises from the mucosal lining of the nasal cavity
and paranasal sinuses.
• It is composed of pleomorphic tumor cells with
necrosis.
• Due to its invasive nature to orbit, it results in
proptosis , cranial nerve palsies, visual
disturbances and pain.
56.
57. Management
• Earlier “orbital exenteration” was done to
complete removal of the contents of the orbit
including the eyelids
• Now a days , “orbital clearance “ is done in
which the globe , muscles , fat and the
periorbita are removed
- Lids , palpebral conjuctiva are preserved for
reconstruction
58. TUMOUR CLINICAL FEATURES AGE OF ONSET TREATMENT
DERMOID CYST Proptosis,Diplopia,
Defective Vision
Childhood
M:F=1:1
Surgical
Resection,Avoid
Rupture
LACRIMAL GLAND
Benign-
PLEOMORPHIC
ADENOMA
Malignant-
ADENOID CYSTIC
CARCINOMA(ACC)
PLEOMORPHIC-
Superotemporal
Mass,S shaped
contour of
lid,Diplopia,Eccente
ric Proptosis,Def Vn
ACC-Pain,Proptosis,
Ptosis,Frontotempo
ral mass,Diplopia
Benign-2ND -5TH
Decade,M:F=1:1
Malignant-Bimodal
2nd and 4th decade,
Peak incidence-4th
decade,F>M
PLEOMORPHIC-
Modified Lateral
Orbitotomy without
capsular rupture
ACC-Well defined-
local excision with
brachytherapy
Radical en block
orbitectomy for
spreading tumours
CAPILLARY
HAEMANGIOMA
Port Wine
stain(Blue violet
discolouration of
lids and
conjunctiva),Propto
sis,squint and
Amblyopia
Infantile Mostly Regress,If
not,then
Radiotherapy,Syste
mic Antifibrinolytic
agents ,Controlled
Resection in worst
cases
59. TUMOUR CLINICAL FEATURES AGE OF ONSET TREATMENT
RHABDOMYOSARCOMA U/L Proptosis,Globe
Displacement,Palpable
mass,Ptosis,Conjunctival
and lid swelling,Diplopia
Most commom
childhood soft
tissue
sarcoma,7-8
yrs mean age
Chemotherapy in
complete resection
of tumour,
Groups 2,3,4-
Radiation of 4500-
5000 cGy in 4-5 wks
Intracranial spread-
whole cranial
irradiation and
intrathecal
chemotherapy
ORBITAL PSEUDOTUMOUR Diagnosis of Exclusion,U/L
Painful Proptosis and
Diplopia,Extra ocular
muscles most commomly
involved
Any age –
Differentiated
from Thyroid
eye disease as
latter spares
the tendinous
insertions of
EOM and not
painful
Steroids-mainstay
60. TUMOUR CLINICAL FEATURES AGE OF ONSET TREATMENT
LYMPHANGIOMA
(Benign)
Proptosis,Blepharoptosis,cell
ulitis,Intraorbital and
Subconj
haemorrhage,squint,glauco
ma,corneal
exposure,hyperopia
Childhood
(Congenital)
Urgent Orbital
surgery if
haemorrhage is
causing optic nerve
compression or on
elective basis for
chronic compression
LYMPHOMAS
B-Cell,Diffuse Large B
cell and Burkitt’s
Lymphoma
B-Cell-Globe
displacement,Proptosis,lymp
hoepithelial lesions of
lacrimal ducts, orbital and
adnexal involvement
6th -7th decade Localised lesions-
local radiotherapy
3000-3500 cGy
Widespread disease-
Chemotherapy
LEUKAEMIA Soft tissue involvement of
the orbit is sudden in acute
leukaemia rather than
chronic,U/L Proptosis
Childhood Local Irradiation and
intrathecal and
systemic
chemotherapy
prolong survival