Mélange of orbital lesions – A histomorphologic study of 135 cases

Abstract

Background: The orbit is an important site for primary and secondary diseases. Various tissue types such as osseous, vascular, neural, muscular, and glandular may be involved with specific pathologies. Tumors can secondarily invade the orbit from the periorbital regions including the paranasal sinuses, eyelids, and intracranial region. Objectives: (i) To assess the histomorphology of various orbital lesions. (ii) To determine the frequency, age, and sex distribution of various orbital lesions in our study population and compare them with the other studies. Materials and Methods: The study involved 135 patients of either sex presenting with orbital lesions reporting to a tertiary care hospital. Results: Among the 135 cases, we observed a slight female predominance, with a female-to-male ratio being 1.17:1. Most of the patients were in their fifth decade and presented with exophthalmos. Histopathologically, cystic lesions were most frequent followed by lymphoproliferative lesions. About 25% of lesions were malignant and included lymphomas, lacrimal gland malignancies, and rhabdomyosarcomas predominantly. We came across a rare case of intravenous papillary endothelial hyperplasia. Conclusion: Orbital lesions arise primarily from soft tissues and bones. The frequency of orbital lesions varies among different series depending on age group, source institution, medical specialty, and geographic areas. Histopathology remains the mainstay of diagnosis. In addition to determining the malignant potential of a lesion, it reveals its exact nature and structure, thereby influencing management and prognosis.

Keywords

• exophthalmos
• orbit
• rhabdomyosarcoma