Orbital and Adnexal Tumours

Tumours are abnormal growths that occur when cells begin to expand out of control. They can be either benign (harmless) or malignant (cancerous). Orbital and adnexal tumours develop from tissue, such as from muscle, nerve, or skin around the eyeball. The orbit – also known as the eye socket – consists of the tissues surrounding the eyeball. The adnexal structures of the eye include the eyelids and tear glands.

Symptoms of orbital and adnexal tumours include:

• Bleeding from the nose, particularly on only one side
• Bulging eyeball
• Change in vision or double vision
• Change or loss of ability to smell
• Closed appearance of the eyelid
• Lump on your eyelid or eye that increases in size over time
• Partial or total loss of vision
• Redness of the eye
• Shadows or flashes of light in your vision
• Sinus pain, pressure, and infections

Types of orbital tumours: 

Orbital tumours often push the eye forward, causing a bulging of the eye (proptosis). The most common causes are thyroid eye disease and inflammatory pseudo tumour; both are benign. Other benign orbital tumours include cavernous haemangioma, inflammatory pseudo tumour, lymphangioma, mucocele, Schwannoma, lacrimal gland pleomorphic adenoma, and arterio-venous malformations. The most common orbital malignancy is lymphoma. In children, most orbital tumours are benign, such as dermoid cyst, capillary haemangioma, lymphangioma, and optic nerve glioma. Common orbital malignancies in children include rhabdomyosarcoma and metastatic neuroblastoma.

Types of adnexal tumours:

The most common type of eyelid cancer is basal cell carcinoma. Other types of eyelid cancer include squamous cell carcinoma, melanoma, sebaceous cell carcinoma, and Lymphoma. Adenoid cystic carcinoma is a rare malignant tumour that is known to be an aggressive cancer of the lacrimal gland.

Tests

Imaging – Your ophthalmologist may recommend you undergo a computerized tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound to aid in the diagnosis of your tumour.

Biopsy – The best way for your doctor to accurately diagnose your orbital or adnexal tumour is for your doctor to surgically obtain a small tissue sample (biopsy) from the affected area, and then send it to the laboratory for analysis.

Treatments

Surgery – When possible, your ophthalmologist will likely recommend the surgical removal of the tumour.

Radiation therapy – If the tumour cannot be removed surgically, you may need to undergo external beam radiation therapy to shrink and destroy the tumour.

Intra-Arterial Cytoreductive Chemotherapy (IACC) – During this treatment, pioneered by Bascom Palmer surgeons, a catheter is introduced into an artery in the thigh and threaded up to the lacrimal gland area. The catheter then delivers a concentrated dose of chemotherapy directly to the tumour. This treatment has improved long-term survival in patients with adenoid cystic carcinoma, an aggressive cancer of the lacrimal gland.