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Anterior Segment Disease > Orbit: Benign and Malignant Lesions > Flashcards

Orbit: Benign and Malignant Lesions Flashcards

1
Q

orbital cavernous hemangioma

A
  • a collection of small blood vessels surrounded by a fibrous pseudocapsule
  • large vascular spaces are within the mass, thus the term cavernous
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2
Q

orbital cavernous hemangioma etiology/associations

A

thought to be a congenital venous malformation

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3
Q

orbital cavernous hemangioma demographics

A
  • typically diagnosed between the ages of 30-50 years

- women > men

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4
Q

orbital cavernous hemangioma laterality

A

unilateral

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5
Q

orbital cavernous hemangioma symptoms

A
  • bulging eye/displaced eye

- double vision

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6
Q

orbital cavernous hemangioma signs

A
  • proptosis
  • globe displacement
  • restricted EOM
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7
Q

orbital cavernous hemangioma complications

A
  • compression on the globe and/or optic nerve

- thrombosis

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8
Q

orbital cavernous hemangioma management

A
  • orbital CT or MRI
  • if symptomatic or complications, refer out
  • complete surgical excision
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9
Q

orbital cavernous hemangioma pearls:

  • most common ____
  • most common location is ____
  • growth may accelerate during _____
A

benign orbital tumor in adults;
within the muscle cone of the orbit;
pregnancy

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10
Q

orbital venous varix (orbital varices)

A

abnormally enlarged vein that becomes dilated with increased venous pressure (e.g., during Valsalva maneuvers, bending forward, or breath holding)

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11
Q

orbital venous varix (orbital varices) etiology/associations

A

thought to be a congenital venous malformation

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12
Q

orbital venous varix (orbital varices) demographics

A

typically diagnosed between the ages of 10-20 years (but can occur later)

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13
Q

orbital venous varix (orbital varices) laterality

A

unilateral

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14
Q

orbital venous varix (orbital varices) symptoms

A
  • intermittent bulging eye/displaced eye

- intermittent double vision

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15
Q

orbital venous varix (orbital varices) signs

A
  • intermittent proptosis
  • intermittent globe displacement
  • intermittent restricted EOM
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16
Q

orbital venous varix (orbital varices) complications

A
  • compression on the globe and/or optic nerve
  • orbital hemorrhage; rapid and painful proptosis
  • thrombosis; rapid and painful proptosis
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17
Q

orbital venous varix (orbital varices) management

A
  • orbital CT or MRI
  • if complications refer out
  • surgery or embolization
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18
Q

orbital venous varix (orbital varices) pearls:

-may also have ____

A

eyelid and conjunctival varices

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19
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor)

A

benign tumor of the lacrimal gland

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20
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) etiology

A

proliferation of epithelial cells

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21
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) demographics

A

typically occurs between the ages of 30-40 years

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22
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) symptoms

A
  • displaced eye
  • double vision
  • eyelid swelling and redness
23
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) signs

A
  • globe displacement inferiorly and medially
  • restricted EOM
  • eyelid edema and erythema
  • palpable lacrimal gland mass
24
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) complications

A

malignant transformation

25
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) management

A
  • orbital CT or MRI
  • refer out
  • complete surgical excision
26
Q

lacrimal gland pleomorphic adenoma (benign mixed cell tumor) pearls:

  • _____ progression occurs over the course of 12 months
  • _____ progression and pain may indicate malignancy
A

slow, painless;

rapid

27
Q

lacrimal gland carcinoma

A

malignant tumor of the lacrimal gland

28
Q

lacrimal gland carcinoma etiology

A
  • adenoid cystic carcinoma: nest of basaloid cells
  • pleomorphic adenocarcinoma: proliferation of epithelial cells; usually develops within a long-standing benign mixed epithelial tumor or as a recurrence of a previously resected benign mixed tumor
29
Q

lacrimal gland carcinoma demographics

A
  • adenoid cystic carcinoma: typically occurs between the ages of 30-40
  • pleomorphic adenocarcinoma: typically occurs in the elderly
30
Q

lacrimal gland carcinoma laterality

A

unilateral

31
Q

lacrimal gland carcinoma symptoms

A
  • displaced eye
  • double vision
  • eye pain
32
Q

lacrimal gland carcinoma signs

A
  • globe displacement inferiorly and medially
  • restricted EOM
  • eyelid edema and erythema
  • palpable lacrimal gland mass
33
Q

lacrimal gland carcinoma complications

A

intracranial extension

34
Q

lacrimal gland carcinoma management

A
  • orbital CT or MRI
  • refer out
  • complete surgical excision
  • exenteration if extensive
  • radiotherapy and chemotherapy
35
Q

lacrimal gland carcinoma pearls:

  • onset of pain is ____
  • five-year survival rate is ____, and at 15 years is _____
  • major cause of death is ____
A

rapid (over 1-3 months);
47%;
only 22%;
intracranial extension

36
Q

orbital lymphoma

A

malignant tumor of the orbit; any part of the orbit may be affected with ~50% of cases affecting the lacrimal gland

37
Q

orbital lymphoma etiology/associations

A

proliferation of lymphocytes

38
Q

orbital lymphoma demographics

A

typically occurs between the ages of 50-70 years

39
Q

orbital lymphoma laterality

A

unilateral > bilateral

40
Q

orbital lymphoma symptoms

A
  • bulging/displaced eye
  • double vision
  • droopy eyelid
  • eyelid swelling
  • eye pain in a minority of cases
41
Q

orbital lymphoma signs

A
  • proptosis
  • globe displacement
  • restricted EOM with possible pain on eye movement
  • ptosis
  • palpable mass if anterior
  • may have pink salmon-patch area of subconjunctival extension
42
Q

orbital lymphoma complications

A
  • compression on the globe and/or optic nerve

- metastasis

43
Q

orbital lymphoma management

A
  • orbital CT or MRI
  • refer out
  • biopsy
  • radiotherapy (external beam) with or without chemotherapy (chemotherapy is considered if there is metastasis)
44
Q

orbital lymphoma pearls:

  • ____% chance of developing systemic lymphoma within 5 years
  • lymphoma represents one end of the spectrum of ____; at the other end of the spectrum is benign reactive lymphoid hyperplasia (demographics, laterality, signs and symptoms are similar, transformation to malignancy can occur)
A

60;

lymphoproliferative lesions;

45
Q

orbital rhabdomyosarcoma

A

malignant tumor of the orbit

46
Q

orbital rhabdomyosarcoma etiology/associations

A

proliferation of primitive mesenchymal stem cells that normally develop into skeletal muscle

47
Q

orbital rhabdomyosarcoma demographics

A
  • infancy to adulthood

- 70% occur between ages of 8-10 years

48
Q

orbital rhabdomyosarcoma laterality

A

unilateral

49
Q

orbital rhabdomyosarcoma symptoms

A
  • bulging/displaced eye
  • double vision
  • droopy eyelid
  • eyelid swelling and redness in a minority of cases
  • ocular pain and redness in a minority of cases
50
Q

orbital rhabdomyosarcoma signs

A
  • proptosis
  • globe displacement
  • restricted EOM with possible pain on eye movement
  • ptosis
  • eyelid edema and erythema
  • conjunctival injection and chemosis
51
Q

orbital rhabdomyosarcoma complications

A
  • compression on the globe and/or optic nerve
  • erosion of orbital bones
  • metastasis
52
Q

orbital rhabdomyosarcoma management

A
  • refer to ED
  • orbital CT or MRI
  • biopsy
  • radiotherapy (external beam) and chemotherapy
53
Q

orbital rhabdomyosarcoma pearls:

  • most common _____
  • ____ new cases per year
  • most common location is the _____
  • can also present, less commonly, in _____
  • hallmarks are _____
  • _____ 5-year survival rate
A 
malignant orbital tumor in children;
~35;
superior nasal orbit;
conjunctiva, eyelid, iris, or ciliary body;
rapid onset and progression;
75-95%
54
Q

orbital rhabdomyosarcoma:

  • ____ has a similar presentation to rhabdomyosarcoma
  • 2nd most common orbital malignancy after rhabdomyosarcoma
  • most common _____
  • usually arises from ____
  • patients typically have sudden _____
  • may develop ____
  • prognosis is _____
A

metastatic neuroblastoma;
pediatric orbital metastatic tumor;
a primary tumor in the abdomen, mediastinum, or neck;
proptosis with eyelid ecchymosis that may be bilateral;
ipsilateral Horner’s syndrome;
poor

Anterior Segment Disease (22 decks)

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