Orbit, Eyelids and Lacrimal system 3 Flashcards Preview

Neuro exam 3 > Orbit, Eyelids and Lacrimal system 3 > Flashcards

Flashcards in Orbit, Eyelids and Lacrimal system 3 Deck (23):
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list adult orbital tumors

1. dermal cysts
2. cavernous hemangioma

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most common benign neoplasm in adults

cavernous hemangioma

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cavernous hemangioma

1. Slowly progressive proptosis
2. Often in middle aged women

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cavernous hemangioma located

1. Retinal striae
2. hyperopia (farsightedness)
3. optic nerve compression
4. increased IOP
5. strabismus

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cavernous hemangioma is diagnosed with

CT or MRI – well encapsulated mass that is enhancing with vasculature on MRI

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Neural Tumors affecting the orbit

1. Meningiomas (primary orbital)
2. Mengangiomas (sphenoid wing)
3. Schwannoma
4. Neurofibroma
5. Optic nerve glioma

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Meningiomas (primary orbital)

1. Less common
2. Usually along arachnoid of optic sheath
3. Women in 3rd and 4th decades of life
4. Gradual, unilateral loss of vision, painless

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Meningiomas (primary orbital)
treatment

1. Observe if no vision loss or spread
2. Radiation if confined to orbit
3. Surgery if severe vision loss and profound proptosis

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Mengangiomas (Sphenoid wing)

1. Hyperplasia of soft tissue and bone
2. Crawls along lateral wall of orbit
3. Dural tail

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Mengangiomas (Sphenoid wing) Treatment

1. Observe until functional problem
2. Subtotal resection
3. Post-op radiotherapy to reduce recurrence

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Schwannoma

1. Proliferation of Schwann cells encapsulated by perineurium
2. Biphasic pattern or solid areas and myxoid areas
3. Hypercellular
4. Excised easily

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Lymphoproliferative Disorders
treatment

1. Radiotherapy
2. Surgery not curative as these are infiltrative
3. Chemo if aggressive

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Lymphoproliferative Disorders

1. can involve orbit
2. Usually B cell tumor
a. Hodgkin and NH Lymphoma
b. Malignant NH Lymphoma very common lymphoproliferative disease of orbit!
3. T-cell tumors are rare

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4 most common lymphomas that go to orbit:

1. MALT
2. CLL
3. Follicular center lymphoma
4. High grade lymphoma

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Lacrimal Gland tumors

Epithelial tumors or non epithelial tumors

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Secondary orbital tumors

Extended to orbit from adjacent structure
1. Globe or eyelid
2. Sinuses

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Globe or eyelid secondary orbital tumors

1. Choroidal melanoma
2. Retinoblastoma
3. Basal and squamous cell carcinomas

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metastatic orbital tumor

1. breast and lung are most orbital metastasis
2. pain, proptosis, inflammation, bone destruction

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Congenital nasolacrimal obstruction

1. Constant tearing with mucopurulence
2. Dacryocystocele

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Constant tearing with mucopurulence

90% resolves in the first year

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Dacryocystocele

1. Enlargement of nasolacrimal sac at birth
2. Obstruction of canaliculus proximally and nasal valve of Hasner distally
3. Fluid trapped in sac = tears and amniotic fluid
4. Large, bluish, cystic structure

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Dacryocystocele complications

Can get intranasal cyst problem since babies are obligate nose breathers

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Dacryocystocele is caused by

Complications of preseptal cellulitis, orbital cellulitis and intranasal cyst