http://bascompalmer.

org/specialties/ocular-oncology-
orbital-tumors/eyelid-periocular-tumors
Chrisfouad R. Alabiad, M.D.
Thomas E. Johnson, M.D.
Bradford W. Lee, M.D., MSc
Wendy W. Lee, M.D., MS
Brian C. Tse, M.D.
David T. Tse, M.D.
Sara T. Wester, M.D., FACS

Eyelid / Periocular Tumors

Tumors of the eyelid may be benign or malignant. A detailed examination with an
Oculoplastic surgeon will help the patient to determine the most appropriate plan for
diagnosis and treatment. In most cases, a biopsy may be performed to determine the cause of
the growth.

The most common type of eyelid cancer is basal cell carcinoma. Other types of eyelid cancer
include squamous cell carcinoma. melanoma and sebaceous cell carcinoma. Most eyelid
malignancies are removed surgically. Removal is often performed by a dermatologist who is
trained in the MOHS micrographic technique. Oculoplastic specialists work closely with the
MOHS surgeon to ensure complete tumor removal and optimal repair of the wound. The
Oculoplastic surgeon will reconstruct the eyelid to provide proper lid function and eye
protection.

Some tumors have the potential to grow into the tissues adjacent to the eye. Following
diagnosis, the surgeon will assist the patient in conducting a full work-up that is tailored to
their specific,individual needs. The Oculoplastic specialists at Bascom Palmer Eye Institute
have developed close working relationships with other specialists at the University of Miami,
including hematology/oncology, radiation oncology, ENT/head and neck surgery, and
neurosurgery. This team oriented approach is undertaken to provide the most expeditious,
optimal outcome for the patient.
Asia Pac J Ophthalmol (Phila). 2017 Mar-Apr;6(2):143-152. doi: 10.22608/APO.201701.

What's New in Eyelid Tumors.

Silverman N1, Shinder R1.

https://www.ncbi.nlm.nih.gov/pubmed/28399340
Abstract

Eyelid malignancies represent between 5% and 10% of all skin cancers. Basal cell carcinoma
is the most common, followed by squamous cell carcinoma, sebaceous cell carcinoma,
Merkel cell carcinoma, and melanoma. The gold standard treatment for periocular epithelial
malignancies is surgical excision. Given the constraints of the anatomy and function of the
eyelids, excision with negative margins and reconstruction can be challenging. In cases of
significant tissue invasion or metastasis, complete tumor removal may not be possible. This
review examines the management of periocular skin cancer from diagnosis and staging,
including the role of sentinel lymph node biopsy, to both surgical and nonsurgical treatment.
The development of targeted drug therapy against specific genetic mutations in cutaneous
malignancies has allowed for the treatment of specific cancer cells with less systemic toxicity
than more traditional treatments.

Copyright 2017 Asia-Pacific Academy of Ophthalmology.

KEYWORDS:

cancer; eyelid; malignancy

Clin Dermatol. 2015 Mar-Apr;33(2):159-69. doi: 10.1016/j.clindermatol.2014.10.008.

Eyelid and ocular surface carcinoma: diagnosis and management.

Yin VT1, Merritt HA2, Sniegowski M1, Esmaeli B3.

https://www.ncbi.nlm.nih.gov/pubmed/25704936

Author information
Abstract

Eyelid cancers account for 5% to 10% of all cutaneous malignancies. The incidence of eyelid
cancer is approximately 15 cases per 100,000 individuals per year. Basal cell carcinoma is by
far the most common cutaneous malignancy in the periocular area; other cutaneous
malignancies that occur in this area include, in decreasing order of frequency, squamous cell
carcinoma, sebaceous carcinoma, melanoma, and Merkel cell carcinoma. The most common
treatment for eyelid carcinomas is surgical resection with frozen section examination for
margin control, but exenteration may be needed when there is orbital invasion. Adjuvant
radiotherapy may be needed in patients at high risk for local recurrence; sentinel lymph node
biopsy may be considered in patients at high risk for lymph node metastasis. Primary or
residual in situ disease of the conjunctiva can be treated with topical chemotherapy, such as
mitomycin C, 5-fluorouracil, or interferon alpha-2 b. For patients with metastatic or locally
advanced basal cell or squamous cell carcinoma not amenable to surgical excision or
radiotherapy, targeted therapy against the hedgehog pathway (for basal cell carcinoma) or
epidermal growth factor receptor (for squamous cell carcinoma) has been shown to be
effective in preventing disease progression. Patients with eyelid and ocular surface
malignancies need to be monitored with careful clinical examination for at least 5years after
surgical treatment, and additional investigations may be warranted in some cases.

Onco Targets Ther. 2017; 10: 24832489.

Published online 2017 May 8. doi: 10.2147/OTT.S130371

PMC full text: << PrevFigure 1Next >>
Copyright/License Request permission to reuse

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5428761/

Figure 1

A patient with BCC on the left lower lid.

Notes: (A) The appearance of the tumor before surgery. (B) One day after MMS surgery and
reconstruction with a flap of upper lid. (C) Three months after surgery. Written informed
consent for publication of photographs was obtained from the patient.

Abbreviations: BCC, basal cell carcinoma; MMS, Mohs micrographic surgery.

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Middle East Afr J Ophthalmol
v.20(3); Jul-Sep 2013
 PMC3757624

Middle East Afr J Ophthalmol. 2013 Jul-Sep; 20(3): 187192.

doi: 10.4103/0974-9233.114788

PMCID: PMC3757624

Eyelid Masses: A 10-year Survey from a Tertiary Eye Hospital in

Tehran
Abbas Bagheri, Mehdi Tavakoli, Azadeh Kanaani, Reza Beheshti Zavareh,1 Hamed Esfandiari, Maryam
Aletaha, and Hossein Salour

Author information Copyright and License information

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Abstract
Purpose:

The purpose of this study was to evaluate the demographics and clinical features of eyelid
masses in a tertiary eye hospital over a 10-year period.

Materials and Methods:

A retrospective chart review was performed for patients admitted with eyelid tumors from
2000 to 2010. Data were collected and analyzed on the demographic features, location of the
tumor, types of treatment, and pathologic findings.

Results:

A total number of 182 patients were evaluated of which, 82 cases were benign and 100 cases
were malignant neoplasms. The most common benign tumors included melanocytic nevi
(35%), papilloma (19.5%), and cysts (11%). The most frequent malignant tumors included
basal cell carcinoma (BCC) (83%), squamous cell carcinoma (8%) and sebaceous gland
carcinoma (6%). The most common site for malignancy was the lower lid followed by the
upper lid. BCC recurred in 16 cases that were most frequent in the lower lid.

Conclusion:

Melanocytic nevus, papilloma and cysts are the most common benign lesions and BCC is the
most common malignant lesion in the eyelids. Recurrence is a feature of BCC especially in
the lower lid.

Keywords: Basal Cell Carcinoma, Eyelid Skin Tumor, Nevus, Papilloma, Squamous Cell Carcinoma

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INTRODUCTION
Approximately, 5% of skin tumors occur in the eyelids.1 Periocular skin and eyelids are
common sites of neoplastic lesions of the head and neck. Eyelid tumors are rarely lethal, but
late diagnosis of the tumors requires more invasive surgery and consequently will have
adverse esthetic effects.2 Aside from esthetic point of view, cutaneous periocular tumors can
block vision or alter the normal shape of the eyelids. Malignant tumors such as basal cell
carcinoma (BCC), squamous cell carcinoma (SCC), sebaceous gland carcinoma (SGC), and
malignant melanoma can affect the eyelids leading to morbidity or even mortality. Several
studies have investigated the incidence, risk factors, and clinical manifestations of eyelid
tumors.1,2 The incidence of eyelid skin tumors is mostly a result of environmental factors
including sunlight and ultra violet exposure and genetic factors including skin pigmentation.
Therefore, the prevalence of these types of tumors shows a geographical variation. The
knowledge of incidence rate of various types of eyelid tumors and their clinical manifestation
can be tremendously helpful in ophthalmology clinics. However, epidemiological studies on
eyelid skin masses in Tehran are rare. The present retrospective study investigated the
epidemiology of eyelid tumors in a tertiary referral center for ophthalmic disorders.

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MATERIALS AND METHODS

This retrospective case series was based on the review of the hospital records of the patients
who had undergone biopsy of their lid lesions from the year 2000 to 2010 in the oculoplastic
section of Labbafinejad Medical Center, Tehran. The Snellen chart was used for
measurement of visual acuity and slit lamp and indirect ophthalmoscope were used for
examination of the anterior and posterior segments of the eye respectively. The lesions were
examined in ambient room lighting and in some cases, photographed. All benign and
malignant tumors (including recurrence) were managed by surgical excision of the lesion. In
cases that were suspected to be malignant or recurrent tumors, management included surgical
excision of the lesion large enough to obtain tumor-free margins, confirmed by histologic
examination. Furthermore in these cases, an oncology consultation was requested in order to
rule out regional lymph nodes involvement and/or distant metastasis. The data sheet filled out
for each patient included age, gender, occupation, the affected eye, the length of time
between the onset of the disease and referral, the symptoms at each visit, visual acuity, the
location and size of the lesion, the physical appearance, limitation of ocular motility,
funduscopic findings, history of trauma, history of tumors in other parts of the body, type of
surgical procedure and the technique for repairing the eyelid, treatment outcomes, the follow-
up examinations, the recurrence of the tumor and the characteristics of the recurrent tumor.
Data were analyzed with SPSS 16.0 software (SPSS Inc., IBM Corp., New York, NY, USA).
P < 0.05 was statistically significant.

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RESULTS
A total of 182 patient charts were reviewed comprised of 82 cases of benign tumors and 100
cases of malignant tumors. The mean age of patients with benign tumors was 46.4 20.7
years. Among patients with benign tumors, 50 cases were female and other 32 were male.
The most common site of involvement was the upper lid (47 cases) followed by the lower lid
(24 cases), medial canthus (5 cases), lateral canthus (2 cases), and combination of these sites
(4 cases). The most prevalent type of the benign eyelid masses were melanocytic nevi (35%)
followed by papillomas (19.5%) and dermoid, epidermoid or inclusion cysts (11%). Some
common types of benign lid tumors have been depicted in Figure 1. The detailed histological
classification of the benign masses is summarized in Table 1.

Figure 1

Common types of benign lid tumors. (a) Pigmented nevus. (b) Papilloma. (c) Apocrine hydrocystoma
and (d) Seborrheic keratosis

Table 1

The histological classification and frequency of benign tumors of the eyelid

In this study, 100 cases of malignant eyelid tumors were diagnosed, which consisted of 83
cases of BCC, eight cases of SCC, six cases of SGC, two cases of malignant melanoma and
one case of lymphoma. Figure 2 shows some common types of malignant tumors. The mean
age of patients with malignant tumors was 63.9 12.5 years. Among patients with malignant
eyelid tumors, 64 patients were male and 36 patients were female. Each patient had one
single malignant tumor. The distribution of the malignant tumors was almost equal for the
left and the right eyelids (52 cases in the left eyelid). Demographic features and location of
the involvement according to the types of the malignancies are shown in Tables Tables22 and
and3.3. The incidence of malignant eyelid tumors in consecutive age groups is shown in
Figure 3. BCC and SCC were more frequent in patients older than 70 (31.3% and 57.1%
respectively). The patients with malignant melanoma and SGC were younger than patients
with BCC and SCC. All cases of malignant melanoma were in their seventh decade of their
life and 50% of the SGC cases were in their sixth decade of their life. The single case of
lymphoma was 71 years old.

Figure 2

Common types of malignant lid tumors. (a) Basal cell carcinoma of the medial canthus. (b) Squamous
cell carcinoma. (c) Sebaceous cell carcinoma and (d) Malignant melanoma

Table 2

The demographic features of patients with malignant eyelid tumors

Table 3

The comparison of the location of malignant tumors of the eyelid

Figure 3

The age distribution of patients with basal cell carcinoma, squamous cell carcinoma and sebaceous
gland carcinoma

Table 3 summarized the site of eyelid tumors in detail. Lower lid was the most common site
of involvement in malignant tumors. The mean length of time between the onset of the
disease and referral of the patient for benign and malignant tumors was 89.3 24.0 and 18.9
12.0 months respectively. Among the malignant tumors, this time was 24 months for BCC,
11.7 months for SCC, 10.2 months for SGC, 9 months for malignant melanoma and 2 months
for lymphoma. The average follow-up of patients with benign and malignant tumors was 78
months with a range of 1-110 months.

Seventeen patients (10 females and 7 males) had tumor recurrence of which 16 cases were
BCC and one case was SCC. Nine cases of the recurrent BCC tumors were in the lower
eyelid, three cases were in the medial canthus, two cases in the upper eyelid, one case in the
lower eyelid and medial canthus and one case in the lateral canthus. The single case of
recurrent SCC occurred in the medial canthus. The mean follow-up for patients with recurrent
tumors following the first surgery was 66 14 months (range: 22-94 months).

We did not observe any significant correlation between the site of BCC and the risk of
recurrence (P = 0.2). However, as shown in Figure 4, the probability of recurrence increased
1.6 times by increasing the size of tumor (95% CI: 0.9-2.6), but a statistically non-significant
correlation existed between the size of primary BCC and the risk of recurrence (P = 0.07).

Figure 4

The correlation of the size of basal cell carcinoma and the risk of tumor recurrence

The recurrence risk was higher in older patients and 75.6% of recurrences were among
patients older than 70 (Pearson test, r = 0.36 and P = 0.03). The length of time between the
onset of the primary lesion and referral was 24.1 7.5 months in patients with recurrent
tumor and 24 8.3 months for patients with non-recurrent tumor (P = 0.4). There was no
significant correlation between gender and the risk of recurrence (P = 0.8).

The single case of SCC recurrence was in the lower eyelid and medial canthus of a 72-year-
old male that happened 1 year after the surgical removal of the tumor. We did not observe
any cases of lymph node enlargement or distant metastasis in our series.

Go to:

DISCUSSION
Eyelid masses are one of the most common pathology examined by ophthalmologists.
Between 2000 and 2010, 182 patients were referred to our clinic for eyelid masses of which
82 (45.05%) cases were benign tumors. Even though, benign tumors are the most frequent
type of eyelid tumors in the general population,3 we observed a higher rate of malignant cases
in our series. Most patients are referred to our clinic due to suspicions lesions that may be
malignant or when a major surgical reconstruction is necessary. Hence, this likely explains
the over-presentation of malignant cases in our study.

In this series, the most common benign tumors were nevi (35%), squamous papillomas
(19.5%) and dermoid or epidermoid cysts (11%). Different studies have reported various
frequencies of benign tumors some of which are similar to our series. For example, 3 separate
studies from China, Southern Taiwan and South Korea the most frequent benign tumors
were, in descending order, nevus, papilloma, and cyst.3,4,5 The most prevalent benign masses
in the studies by Kersten et al.6 and Ni7 were papilloma. In the study by Hsu and Lin8 the
most frequent type of benign tumors in patients was dermoid cysts. In a survey from Saudi
Arabia, the most common benign mass was hidrocystoma followed by chalazion.9 Some of
these disparities are interesting due to demographic differences. For instance, in Hsu and
Lin's study8 that reported dermoid cysts as the most frequent tumor, only pediatric and
adolescent patients below 17 years were investigated. Certain geographic and climate
conditions can also influence the frequency of different type of eyelid masses, for example,
the higher incidence of hidrocystoma in a Saudi study9 is attributed, by the author, to the
warm climate and excessive activity of sudoriferous glands in the inhabitants of this region.9

In our study, the mean age of patients with benign eyelid tumors was 47 years and they were
more prevalent among females with greater involvement of the upper eyelid (57%). In the
study of over 5,500 cases of eyelid skin tumors in a Swiss cohort, 84% were benign tumors,
the most common being squamous papilloma followed by seborrheic keratosis. The mean age
in these two common types of benign tumors were 56 years and 69 years, respectively. The
gender distribution in most cases of benign epidermal masses was equal. There was greater
involvement of the upper eyelid in some pathologic lesions including papilloma, inverted
follicular keratosis and dermoid cysts. Keratoacanthoma, solar keratosis and Bowen's disease
were more common in the lower eyelid and in several cases both eyelids were equally
involved.10 In a similar study from Thailand, 51% of benign tumors originated from the upper
eyelid.11 Similarly, a study from Southern Taiwan reported 46% of benign cases were located
in the upper eyelid.4 In contrast, a Chinese study, reported the lower eyelid was involved
slightly more frequently than upper eyelid.3

The three most common malignant tumors in our study were BCC (83%), SCC (8%), and
SGC (6%). Studies from other countries have reported difference types and frequencies of
malignant eyelid tumors, some of these reports have been concised in Table 4.3,4,10,11,16,17

Table 4

The frequency of different types of malignant eyelid tumors in various countries

In most of the studies from other countries, BCC is the most frequent malignant tumor of the
eyelid.3,4,10,16 Of note, the frequency of SGC is higher in Asian countries.3,4,11,17 However, in
most Western countries, more than 85% of the cases are BCC.10,16 Genetic factors, ethnicity,
geographical region, latitude, and people protecting themselves from sunlight can influence
the prevalence of different types of eyelid tumors.

In the present study, the mean age of patients with malignant tumors was above 60. This
finding is in agreement with most of the aforementioned studies as well as the study by
Vitaliano and Urbach12 who consider age an important risk factor in non-melanoma skin
tumors. In our series, two patients under 40 and 13 patients under 50 had BCC. Similar
incidences of BCC have been reported in other studies in younger patients. Genetic
abnormalities and rare syndromes such as basal cell nevus syndrome and xeroderma
pigmentosum are possible among these younger patients with malignant eyelid tumors.13,14

In general, 20% of BCC occur in the periocular area of which half of the cases present in the
lower eyelid, one-third in the medial canthus, 15% in the upper eyelid and 5% in the lateral
canthus.14,15 Similarly, in the present study, most (61.4%) cases of BCC were in the lower
eyelid. However, the incidence of BCC was lower in medial canthus compared to most of the
other studies.16 In our study, the incidence of BCC in the medial canthus and lateral canthus
was similar.

In this study, the longest period between the onset of disease symptoms and referral was that
of BCC (24 months) and the shortest time was related to lymphoma. In general, BCC
progress very slowly and is asymptomatic in the early phase. These tumors can appear as a
pearly nodule accompanied with fine telangiectasia and minimal ulceration. BCC lesions can
manifest with typical appearance such as nodular, pigmented, ulcerous, and morphea-form.
The most common type is the nodular BCC.14,15 Similar to our study, Takamura and
Yamashita17 reported that BCC had the longest time between the onset of the disease and
referral (40 months) followed by SGC (11 months), SCC (10 months) and finally lymphoma
(1 month). Commonly, BCC patients are aware of the presence of a lesion for an extended
period of time before visiting a physician and diagnosis.13 According to one study, 15 such
patients were aware of a lesion at least 5 years prior to diagnosis.17 Therefore, due to the slow
progression of BCC, a prompt biopsy of any eyelid lesion is highly recommended.18

In the present study, with a mean of 6.5 years follow-up of patients, there were 16 recurrent
cases of BCC and one case of recurrent SCC. The risk factors for recurrence of tumors in
previous studies include the size of the primary tumor (recurrence is more than 40% in
tumors larger than 2 cm and is less than 10% in tumors smaller than 2 cm), the type and the
shape of the lesion and the site of the tumor in the medial canthus.14 The treatment strategy
can also influence the recurrence rate. In our study, with four cases of tumors in the medial
canthus, three recurred (75%). The recurrence rate for the tumors in the lower eyelid was
14% in our study. In addition, recurrence was related to the size of the primary tumor. In
agreement with the findings of other studies,14 we observed that the risk of recurrence
increases with increasing size of the primary tumor.

In a comprehensive review published in 1989,19 all the studies related to BCC were analyzed.
According to the finding of this review,19 less than one third of the recurrent cases occur in
the 1st year after surgery. Nearly, 50% of the recurrent cases occur within the 2nd year and
two-thirds occur within the first 3 years postoperatively. Another finding was that the
recurrence rate in a 10-year follow-up is twice the rate of 2-year follow-up and 18% of
recurrence occurs between the 5th year and the 10th year.19 Thus, these results provide
evidence for the importance of the long-term follow-up of the patients specially the patients
with risk factors for recurrence.19 In addition, diagnosis of recurrence is tremendously
important within the first few years after surgery, as the risk of recurrence is higher during
this time.

Our research is the first epidemiological study of eyelid skin masses in Tehran. Due to the
difference of available statistical data depending on the country and geographical region, our
data provides novel information regarding demographic and histological features of eyelid
tumors in our region. These epidemiological studies are extremely beneficial for the
practicing ophthalmologists and the training residents and also for public health-care
planning. In addition, our study highlights the importance of future research in this field and
the benefits of standardized data collection techniques.

Go to:

Footnotes
Source of Support: Nil

Conflict of Interest: None declared.

Go to:

REFERENCES
1. Cook BE, Jr, Bartley GB. Treatment options and future prospects for the management of eyelid
malignancies: An evidence-based update. Ophthalmology. 2001;108:208898. [PubMed]

2. Hilovsky JP. Lid lesions suspected of malignancy. J Am Optom Assoc. 1995;66:5105. [PubMed]

3. Xu XL, Li B, Sun XL, Li LQ, Ren RJ, Gao F, et al. Eyelid neoplasms in the Beijing Tongren Eye Centre
between 1997 and 2006. Ophthalmic Surg Lasers Imaging. 2008;39:36772. [PubMed]

4. Chang CH, Chang SM, Lai YH, Huang J, Su MY, Wang HZ, et al. Eyelid tumors in southern Taiwan: A
5-year survey from a medical university. Kaohsiung J Med Sci. 2003;19:54954. [PubMed]

5. Chi MJ, Baek SH. Clinical analysis of benign eyelid and conjunctival tumors. Ophthalmologica.
2006;220:4351. [PubMed]

6. Kersten RC, Ewing-Chow D, Kulwin DR, Gallon M. Accuracy of clinical diagnosis of cutaneous eyelid
lesions. Ophthalmology. 1997;104:47984. [PubMed]

7. Ni Z. Histopathological classification of 3,510 cases with eyelid tumor. Zhonghua Yan Ke Za Zhi.
1996;32:4357. [PubMed]

8. Hsu HC, Lin HF. Eyelid tumors in children: A clinicopathologic study of a 10-year review in southern
Taiwan. Ophthalmologica. 2004;218:2747. [PubMed]

9. Al-Faky YH. Epidemiology of benign eyelid lesions in patients presenting to a teaching hospital.
Saudi J Ophthalmol. 2012;26:2116. [PMC free article] [PubMed]

10. Deprez M, Uffer S. Clinicopathological features of eyelid skin tumors. A retrospective study of
5504 cases and review of literature. Am J Dermatopathol. 2009;31:25662. [PubMed]
11. Pornpanich K, Chindasub P. Eyelid tumors in Siriraj Hospital from 2000-2004. J Med Assoc Thai.
2005;88:S114. [PubMed]

12. Vitaliano PP, Urbach F. The relative importance of risk factors in nonmelanoma carcinoma. Arch
Dermatol. 1980;116:4546. [PubMed]

13. Margo CE, Waltz K. Basal cell carcinoma of the eyelid and periocular skin. Surv Ophthalmol.
1993;38:16992. [PubMed]

14. Allali J, DHermies F, Renard G. Basal cell carcinomas of the eyelids. Ophthalmologica.
2005;219:5771. [PubMed]

15. Perlman GS, Hornblass A. Basal cell carcinoma of the eyelids: A review of patients treated by
surgical excision. Ophthalmic Surg. 1976;7:237. [PubMed]

16. Cook BE, Jr, Bartley GB. Epidemiologic characteristics and clinical course of patients with
malignant eyelid tumors in an incidence cohort in Olmsted County, Minnesota. Ophthalmology.
1999;106:74650. [PubMed]

17. Takamura H, Yamashita H. Clinicopathological analysis of malignant eyelid tumor cases at

Yamagata university hospital: Statistical comparison of tumor incidence in Japan and in other
countries. Jpn J Ophthalmol. 2005;49:34954. [PubMed]

18. Lober CW, Fenske NA. Basal cell, squamous cell, and sebaceous gland carcinomas of the
periorbital region. J Am Acad Dermatol. 1991;25:68590. [PubMed]

19. Rowe DE, Carroll RJ, Day CL., Jr Long-term recurrence rates in previously untreated (primary)
basal cell carcinoma: Implications for patient follow-up. J Dermatol Surg Oncol. 1989;15:31528.
[PubMed]

Common types of malignant lid tumors. (a) Basal cell carcinoma of the medial canthus. (b) Squamous
cell carcinoma. (c) Sebaceous cell carcinoma and (d) Malignant melanoma

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Am J Ophthalmol. 2004 Jun;137(6):1065-72.
Intraorbital and periorbital tumors in children--value of ultrasound
and color Doppler imaging in the differential diagnosis.
Neudorfer M1, Leibovitch I, Stolovitch C, Dray JP, Hermush V, Nagar H, Kessler A.

Author information
https://www.ncbi.nlm.nih.gov/pubmed/15183791

Abstract
PURPOSE:

To evaluate the role of ultrasonography (US) and color Doppler imaging (CDI) in the
diagnosis of orbital tumors in children.

DESIGN:

Retrospective nonrandomized interventional case series.

METHODS:

This study included 42 children with intraorbital and periorbital tumors who were evaluated
in our clinic. All children underwent a complete clinical evaluation as well as orbital US and
CDI. The children then underwent operation or were followed up, based on the clinical
diagnosis and the findings on the imaging modalities.

RESULTS:

The mean age of the patients at diagnosis was 22.5 months (range 2 weeks-14 years old).
Eighteen patients (12 female and 6 male) were diagnosed with hemangioma based on the
findings in US and CDI; 16 patients (9 female and 7 male) were diagnosed with dermoid, 5
patients (4 female and 1 male) with lymphangioma, 2 patients with rhabdomyosarcoma, and
1 patient with a subperiostal abscess. Twenty-two patients underwent operation, and the
diagnosis was confirmed on pathology. Twenty patients did not undergo operation and
continued to be followed up in the clinic (mean follow-up period 38.2 months). The disease
course in all patients who did not undergo operation was consistent with the working
diagnosis.

CONCLUSION:

Both US and CDI are useful modalities in the diagnosis of intraorbital and periorbital tumors
in the pediatric age group.
Taylor and Hoyt's Pediatric Ophthalmology and Strabismus E-Book
By Scott R. Lambert, Christopher J. Lyons