Abstract
The demographics, clinical features, and histopathological classification of orbital space-occupying lesions in adults have not been widely described in our part of the world except for the pediatric population. In this retrospective study, we collected 110 consecutive adult patients (18 years and older) with orbital lesions (excluding lacrimal gland lesions) that were diagnosed histopathologically in two tertiary eye centers in Riyadh, Saudi Arabia (January 2000 to July 2017). Patients with thyroid-related orbitopathy, infectious, and inflammatory/pseudo-inflammatory lesions were excluded. We had 60 males (54.5%) and 50 females (45.5%). The mean age at presentation was 51.4 years (range 19–99). Proptosis was the most common clinical presentation (mean duration 15.4 months). The orbital lesions in order of increasing prevalence were: lymphoproliferative lesions in 26.4%; vascular in 21.8%; secondary tumors in 14.6%; neurogenic in 13.6%; structural in 10.0%; soft tissue tumors 8.2%; then metastatic tumors (2.7%) and others (extramedullary leukemia, fibrous dysplasia, and histiocytic lesion: Rosai-Dorfman disease): one case each. Gender distribution was varied in lymphoproliferative disorders compared to vascular lesions. Cavernous hemangioma was the most common vascular lesion (83.3%) and schwannoma was the most common neurogenic tumor (60%). Secondary lesions extended to the orbit mostly from eyelids in nine out of 16 or conjunctiva in four out of 16 cases. A favorable outcome was observed in about 80% of patients who underwent excisional biopsy. The rest encountered local recurrence of the tumors, growing of residual lesions, and recurrence with further invasion to nearby structures. We concluded having a similar demographic pattern of orbital lesions in adults as has been universally reported. We have fewer secondary tumors. We have summarized the pathological profile of adult orbital lesions according to patients’ age, gender, symptoms, and location of the lesion as a baseline guide for proper diagnosis of any orbital mass prior to surgical management planning and for future prognostic studies.
Article PDF
Avoid common mistakes on your manuscript.
References
Costin BR, Perry JD, Foster JA. Classification of orbital tumors. In: Perry JD. Clinical ophthalmic oncology. Berlin, Heidelberg: Springer-Verlag; 2014, pp. 9–14.
Shields JA, Bakewell B, Augsburger JJ, Flanagan JC. Classification and incidence of space-occupying lesions of the orbit: a survey of 645 biopsies. Arch Ophthalmol 1984;102;1606–11.
Alkatan HM, Al Marek F, Elkhamary S. Demographics of pediatric orbital lesions: a tertiary eye center experience in Saudi Arabia. J Epidemiol Glob Health 2019;9;3–10.
Shields JA, Shields CL, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: the 2002 Montgomery Lecture, part 1. Ophthalmology 2004;111;997–1008.
Shields JA, Bakewell B, Augsburger JJ, Donoso LA, Bernardino V. Space-occupying orbital masses in children: a review of 250 consecutive biopsies. Ophthalmology 1986;93;379–84.
Bonavolontà G, Strianese D, Grassi P, Comune C, Tranfa F, Uccello G, et al. An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthal Plas Receonstr Surg 2013;29;79–86.
Demirci H, Shields CL, Shields JA, Honavar SG, Mercado GJ, Tovilla JC. Orbital tumors in the older adult population. Ophthalmology 2002;109;243–8.
Shinder R, Al-Zubidi N, Esmaeli B. Survey of orbital tumors at a comprehensive cancer center in the United States. Head Neck 2011;33;610–14.
Johansen S, Heegaard S, Bøgeskov L, Prause JU. Orbital spaceoccupying lesions in Denmark 1974–1997. Acta Ophthalmol Scand 2000;78;547–52.
Ohtsuka K, Hashimoto M, Suzuki Y. A review of 244 orbital tumors in Japanese patients during a 21-year period: origins and locations. Jpn J Ophthalmol 2005;49;49–55.
Khan AA, Sarwar S, Sadiq MAA, Ur Rehman M, Ullah A, Ahmad I. Analysis of 1246 cases of orbital lesions: a study of 17 years. Nat Sci 2015;7;324–37.
Bonavolontà P, Fossataro F, Attanasi F, Clemente L, Iuliano A, Bonavolontà G. Epidemiological analysis of venous malformation of the orbit. J Craniofac Surg 2020;31;759–61.
Malik MOA, El Sheikh EH. Tumors of the eye and adnexa in the Sudan. Cancer 1979;44;293–303.
Günalp I, Gündüz K. Secondary orbital tumors. Ophthal Plast Reconstr Surg 1997;13;31–5.
Seregard S, Sahlin S. Panorama of orbital space-occupying lesions. The 24-year experience of a referral centre. Acta Ophthalmol Scand 1999;77;91–8.
Bernardini FP, de Conciliis C, Schneider S, Kersten RC, Kulwin DR. Solitary fibrous tumor of the orbit: is it rare? Report of a case series and review of the literature. Ophthalmology 2003;110;1442–8.
Shields JA, Shields CL, Brotman HK, Carvalho C, Perez N, Eagle RC. Cancer metastatic to the orbit: the 2000 Robert M. Curts Lecture. Ophthal Plast Reconstr Surg 2001;17;346–54.
Char DH, Miller T, Kroll S. Orbital metastases: diagnosis and course. Br J Ophthalmol 1997;81;386–90.
Roh KK, Lee JH, Youn DH. Clinical analysis of tumors of the eye and its adnexa. Korean J Ophthalmol 1988;2;27–31.
Asadi-Amoli F, Nozarian Z, Bonaki HN, Mehrtash V, Entezari S. Clinicopathologic assessment of ocular adnexal lymphoproliferative lesions at a tertiary eye hospital in Iran. Asian Pac J Cancer Prev 2016;17;3727–31.
Harris GJ, Jakobiec FA. Cavernous hemangioma of the orbit. J Neurosurg 1979;51;219–28.
Markowski J, Jagosz-Kandziora E, Likus W, Pająk J, Mrukwa-Kominek E, Paluch J, et al. Primary orbital tumors: a review of 122 cases during a 23-year period: a histo-clinical study in material from the ENT Department of the Medical University of Silesia. Med Sci Monit 2014;20;988–94.
Tang W, Hei Y, Xiao L. Recurrent orbital space-occupying lesions: a clinicopathologic study of 253 cases. Chin J Cancer Res 2013;25;423–9.
Author information
Authors and Affiliations
Corresponding author
Additional information
Data availability statement: The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.
Rights and permissions
This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
About this article
Cite this article
Alsalamah, A.K., Maktabi, A.M.Y. & Alkatan, H.M. Adult Orbital Lesions in Saudi Arabia: A Multi-centered Demographic Study with Clinicopathological Correlation. J Epidemiol Glob Health 10, 359–366 (2020). https://doi.org/10.2991/jegh.k.200720.001
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2991/jegh.k.200720.001