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Proptosis is a common finding in orbital diseases. It can be due to congenital, inflammatory, infectious, neoplastic and miscellaneous disorders.
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PLEOMORPHIC L G ADENOMAPRE.:- painless, firm, non-tender
CT scanTre.:- surgery
MALIGNANT LG TUMOURFast growing PainfulCT scan Tt.:- radiotherapy, surgery.
RHABDOMYOSARCOMAMost common primary malignant
orbital tumour in children.The four main histological type :-
1. Embryonal 3. Botyroid 2. Alveolar 4. Pleomorphic
CLINICAL FEATURESPresentation:- first decade of life with a
rapidly progressive proptosis. Examination:- diagnosis is conformed by
biopsy.Systemic investigations:-CT of the chest,
abdomen & pelvis, liver function test,bone marrow biopsy, and skeletal radiographs.
RHABDOMYOSARCOMA
TREATMENT Radiotherapy:-Chemotherapy:-Exenteration:-
DERMOID CYSTA benign cystic teratoma :-The two main types:- 1. Superficial 2 . Deep
SUPERFICIAL DER0MOID CYST
Located anterior to the orbital septum.Presentation:-infancy, firm, round,
attachment to suture.Treatment is based on cosmetic
indications.
DEEP DERMOID CYST Located posterior to the orbital septum.
Presentation:-adolescence, proptosis.
Treatment:-excision.
BLOOD CYST Relatively rare:- May be associated with blunt trauma, lymphangioma, venous anomalies and blood dyscrasia.
Presentation:- progressive, non- tender proptosis.
MUCOCELEFrontal EthmoidPresentation:- diplopia, proptopsis.
MACOCELE OF LEFT FORNTAL SINUS
OPTIC NERVE GLIOMAA slow-growing tumour.Affect in adults.Presentation:- visual loss first , proptosis.Examination:-disc oedema , atrophy.
CT scan, fusiform enlargement of ONTreatment:-
1. Observation. 3. Surgical 2. Radiotherapy
MENINGIOMAOptic nerve sheathRare Middle aged womenPre.:- slowly progressive, U L ,visual loss.Examination:- ocular movement restriction
proptosis, disc oedema, atrophy. CT scan - tubular thickning of ON
TREATMENTOBSERVATION RADIOTHERAPY EXCISION
METASTATICChildren Neuroblastoma Ewing sarcoma Acute myeloid leukaemia
ACUTE MYELOID LEUKAEMIA
METASTATICAdult Breast Bronchus Prostate GIT
TREATMENTRadiotherapy HormonalChemotherapySurgery
ADJACENT STRUCTURESMaxillary ca.Ethmoidal ca.
N P
PRESEPTAL CELLULITIS
ORBITAL CELLULITIS
CAPILLARY HAEMANGIOMA
CAPILLARY HAEMANGIOMA
BILATERAL ORBITAL INVOLVEMENT BY LYMPHOMA
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