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Orbital and Adnexal Tumors

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Orbital and adnexal tumors are abnormal growths that develop in the tissues around the eye, including muscles, nerves, skin, eyelids, and tear glands. These tumors can be benign (non-cancerous) or malignant (cancerous). The orbit refers to the eye socket and its surrounding tissues, while the adnexal structures include the eyelids and tear-producing glands.

Symptoms

  • Bulging of the eyeball (proptosis)
  • Vision changes or double vision
  • Partial or total loss of vision
  • Redness of the eye
  • Shadows or flashes in vision
  • Bleeding from one side of the nose
  • Closed or drooping appearance of the eyelid
  • Lump on the eyelid or near the eye that grows over time
  • Sinus pain, pressure, or repeated infections
  • Changes or loss of smell

Types of Tumors

Orbital Tumors

Often cause bulging of the eye.

Common benign tumors: thyroid eye disease, inflammatory pseudotumor, cavernous hemangioma, lymphangioma, mucocele, Schwannoma, lacrimal gland pleomorphic adenoma, arteriovenous malformations.

Common malignant tumors: lymphoma.

In children: most orbital tumors are benign (dermoid cyst, capillary hemangioma, lymphangioma, optic nerve glioma), while malignant tumors include rhabdomyosarcoma and metastatic neuroblastoma.

Adnexal (Eyelid and Tear Gland) Tumors

Most common eyelid cancer: basal cell carcinoma.

Other types: squamous cell carcinoma, melanoma, sebaceous cell carcinoma, lymphoma.

Rare malignant lacrimal gland tumor: adenoid cystic carcinoma, known for its aggressive nature.

Tests & Diagnosis

Imaging: CT scan, MRI, or ultrasound to locate and evaluate the tumor.

Biopsy: A tissue sample is surgically obtained and analyzed to confirm the tumor type.

Treatments

  • Surgery: Preferred when the tumor can be safely removed.
  • Radiation Therapy: Used when surgery is not feasible, to shrink or destroy the tumor.
  • Intra-Arterial Cytoreductive Chemotherapy (IACC): A specialized treatment pioneered at Bascom Palmer that delivers concentrated chemotherapy directly to the tumor through an artery, improving long-term survival for aggressive lacrimal gland cancers.

Why Choose Bascom Palmer Eye Institute?

Ranked #1 by U.S. News & World Report

  • Top-rated facility in the country for eye care.

Multidisciplinary Collaboration

  • Unmatched experience treating both routine and complex cases.

Dr. Nasser Ibrahim Al-Rashid Orbital Vision Research Center

  • The world’s first research center dedicated to finding novel, cure-focused treatments for orbital diseases.

Comprehensive Care:

  • Our experienced oculoplastic surgeons specialize in treating both common and rare orbital and adnexal tumors, ensuring optimal health and vision outcomes.

FAQ

What are orbital and adnexal tumors, and are they always dangerous?
Orbital tumors lurk in the socket (e.g., optic gliomas pressing nerves), adnexal in lids/conjunctiva (chalazia to lymphomas)—benign like dermoids (cystic lumps) outnumber malignant, but growth can bulge eyes or blur sight. Rare (1 in 100,000 kids yearly for rhabdomyosarcoma), they’re often incidental finds, treatable with vision-sparing flair.
Painless proptosis (eye push-forward), lid swelling, or vision dips from compression; kids might rub chronically, adults note asymmetry in mirrors. Inflammatory mimics (thyroid) confuse, but persistent mass mandates imaging—early spots save sockets.
Orbital MRI/CT delineates borders without invasion, ultrasound quick for adnexal; fine-needle aspiration or excisional biopsy confirms cell type—pathology plus genetics (e.g., FOXL2 in dermoids) stages risk. Multiteam: ophthalmo-onco plots paths.
Benign: surgical shave or marsupialize; malignant: chemo/radiation pre-debulk, sparing globe via plaque. Immunotherapy emerges for lymphomas—90% benign cure, 70% malignant control with function intact.
Serial scans quarterly fading to yearly, field tests track deficits; prosthetics cosmetic if needed. Recurrence low (<10% benign), support groups bond survivors—many gaze gratefully, anomalies archived.

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