Orbital biopsy: Is it worth it? a 10-year review

Abstract

Purpose: The purpose of the study was to evaluate the contribution of orbital biopsy for the management of patients with an orbital mass of unknown etiology using the Greenwich Grading System (GGS). Methods: This was a retrospective case series conducted at a tertiary hospital over a period of 10 years (2007–2017). Case records of all patients with an orbital mass were reviewed. All relevant data collected from the medical records electronic database were analyzed. The GGS was used to assess the contribution of orbital biopsy for the diagnosis, investigation, and treatment of each patient. Results: Ninety-two medical records were reviewed; 34 patients underwent orbital biopsy. The mean age was 53 ± 26 years and 58.7% were female. In the biopsied group, the most common histopathological diagnoses were lymphoma (44.1%), nonspecific orbital inflammation (14.4%), and squamous cell carcinoma (8.8%). After the biopsy, a new diagnosis was obtained in 41.2%, although in most patients (58.8%), the biopsy confirmed the suspected diagnosis. Regarding the therapeutic management, 32.4% started a new treatment, 29.4% did not change their treatment, 32.4% altered/stopped their treatment, and 5.9% allowed reassurance and explanation for the patients. Conclusions: Orbital biopsy was considered a valuable investigation for the management of patients with an orbital mass of unknown etiology. In most cases (58.8%), the result of the biopsy confirmed the suspected diagnosis, and in around 41.2%, a new diagnosis was made. Most of the patients (64.8%) changed their treatment or started a new one based on the histopathological result.

Keywords

• greenwich grading system
• histopathological result
• orbital biopsy