35 year old woman with protrusion of right eye		CT scan showing huge orbital tumor behind right eye(cross)

About Orbital Tumors: General Information

The orbit is the bony box in which the eye lies. Tumors and inflammations can occur behind the eye. They often push the eye forward causing a bulging of the eye called proptosis.

Tumors and inflammations can occur behind the eye. They often push the eye forward causing a bulging of the eye called proptosis. The most common causes of proptosis are thyroid eye disease and lymphoid tumors (lymphoma and atypical lymphoid hyperplasia).

Other tumors include vascular tumors (e.g. hemangiomas, lymphangioma), lacrimal gland tumors (e.g. dacryoadenitis, benign mixed tumor, sarcoidosis and adenoid cystic carcinoma), and growths that extend from the sinuses into the orbit (e.g. squamous carcinoma, mucocele). Metastatic cancer can also form an orbital tumor. Lastly, an orbit tumor can also be caused by inflammation (e.g. pseudotumor, sarcoidosis) or infection (abscess).

Symptoms
Most patients with orbital tumors notice a bulging of the eyeball. Infections, inflammations and certain orbital cancers can also cause pain. Less commonly, orbital tumors may be an incidental finding on CT or MRI of the head, sinuses and orbit.

Diagnosis
Though CT, MRI’s and ultrasound can help in determining the probable diagnosis, most orbital tumors are diagnosed by a surgical biopsy called an orbitotomy (anterior or lateral). A specimen is sent to an ophthalmic pathologist who helps determine the exact diagnosis.

Treatments
When possible, orbital tumors are totally removed by Dr. Shome using the latest techniques in orbital surgery. Surgery is delicate as the goal of vision is to prevent damage to the optic nerve which is responsible for sight. The orbital structures are full of nerves and vessels and prevention of damage to these requires adequate expertise and training. If the tumor cannot be completely removed or if removal will cause too much damage to other important structures around the eye, a piece of tumor may be removed by Dr. Shome and sent for evaluation by an eye-pathologist. Occasionally an orbital tumor is too big or involves the sinuses and requires more extensive surgery with bone-flaps.

If tumors cannot be removed during surgery, most orbital tumors can be treated with external beam radiation therapy. Certain rare orbital tumors require removal of the eye and orbital contents. In certain cases orbital radiotherapy may be used to treat any residual tumor (in an effort to spare vision and the eye).

	Orbital tumor measuring 40 mm removed surgically via lateral and medial orbitotomy; Patient maintained perfect vision post-surgery.