The authors refer about diagnostic procedures, treatment and follow-up of 87 adult patients with orbital
tumors during the period 1998 - 2007 in the Department of Ophthalmology, Faculty Hospital Královské Vinohrady, Charles University, Prague, Czech Republic, E.U. The group consists of 42 men and 45 women, age range 18-89 years. In 49 patients, the
tumors were of benign origin (age 18-80 years, median, 48 years), and 38 patients suffered from malign
tumors (age 38-89 years, median, 61 years). Among basic examinations methods ranked the magnetic resonance imaging and the histological verification of the
tumor. Sixty-four
tumors were treated by means of 70
surgical procedures. The anterior diagnostic or therapeutic orbitotomy was used in 72.5% of the cases, lateral osteoplastic orbitotomy (Kronlein) in 14.5%, and exenteration of the orbit in 13% of the cases. Altogether 23 patients were treated without surgery by means of
corticosteroids, or are followed-up due to a benign
tumor only. As the most common, the
inflammatory pseudotumors of the orbit were diagnosed in 40%. Clinically they were of the anterior nodular, or posterior diffuse form,
dacryoadenitis or
orbital myositis. All patients were treated by means of prednisolon for at least three months; due to the relapse of the immunopathologic process, in 16 % of the cases the
therapy was supplemented with azathioprime. The
surgical procedure was the choice of treatment in 66% of inflammatory processes in the lacrimal gland region. In four cases the
sarcoidosis was established.The second
tumor in the final ranking was
lymphoma in 19.5%; the
MALT-lymphoma was diagnosed in 59% of these cases. The
chemotherapy was chosen for the treatment in 2/3 of the cases, and in all cases the remission was reached.The
actinotherapy was chosen especially in other types of
lymphoma; the follicular form and "molding"
lymphoma were the causes of the death in two patients. Among malignant
tumors, the most serious clinical courses were histological different primary
carcinomas of the orbitopalpebral region in 14% of the cases, and secondary
melanoma spreading from the conjunctiva in 5.5%. Both these
tumors, counting the same number as
lymphomas, were the only indications to the exenteration of the orbit, and causes of the death in four patients.
CONCLUSION: