The orbit: Biopsy, excision biopsy, and exenteration specimens

Abstract

Imaging advances has improved the preoperative assessment of space-occupying masses in the orbit but biopsy is still important in the definitive diagnosis of an orbital mass. Most orbital problems cause proptosis or disorders of ocular motility. In adults the commonest pathology includes vascular tumours, lymphoma, chronic idiopathic orbital inflammatory disease and tumours of the periorbital and lacrimal gland. Tumours of the bone and soft tissues are relatively rare. The most common tumours of the lacrimal gland are pleomorphic adenoma and adenoid cystic carcinoma. In children benign cysts, including dermoid cysts, vascular tumours, sarcomas and tumours of the optic nerve predominate. Rhabdomyosarcoma is the most common primary sarcoma of the orbit and can form a rapidly expanding mass in children. Optic nerve tumours are associated with neurofibromatosis type 1. They are termed optic nerve glioma but show identical morphology to pilocytic astrocytomas.