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Orbital Tumors

Determining the Type of Orbital Tumor

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer.

Because of the anatomy of the orbit, it is possible to have many different types of tumors in the orbit. Some tumors are benign, or noncancerous (such as neurofibromas, hemangiomas, osteomas), but some are malignant (cancerous). Also, there are some benign tumors that can behave aggressively and cause destruction as they grow, so they are often treated as though they are cancer.

Note that most cancers of the orbit are actually from sinonasal cancers growing into the orbit. See the Nose and Sinus Cancers section to learn more about those tumors.

One convenient way to break down orbital cancers is to look at orbital tumors in children versus adults.

Pediatric orbital cancers can include the following:

  • Rhabdomyosarcoma is the most common cancer that starts in the orbit in children.
  • Retinoblastoma is the most common tumor inside the eyeball in children.
  • Neuroblastoma is the most common cancer to spread to the orbit in children.
  • Lymphoma
  • Leukemia

Adult orbital tumors are usually malignant and can include:

  • Lymphoma: This is the most common type of tumor that starts in the orbit in adults. Lymphoma is a cancer of the blood in which specific white blood cells (called lymphocytes) become cancerous. Even though lymphoma is a blood cancer, it usually presents as a solid tumor somewhere in the body.
  • Lacrimal gland cancers: These are very similar to salivary gland cancers, and they can be of the same type, including:
    • Adenoid cystic carcinoma
    • Malignant mixed tumor
    • Adenocarcinoma
    • Mucoepidermoid carcinoma
  • Lacrimal sac cancers: These can include squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma, salivary gland carcinoma and poorly differentiated carcinoma.
  • Cancers of the skin of the eyelid: These can include squamous cell carcinoma, basal cell carcinoma and even rare tumors such as sebaceous cell carcinoma and Merkel cell carcinoma. Actually, the most common place for a sebaceous gland carcinoma to arise is on the eyelid. Though skin cancers of the eyelid are staged differently than skin cancers in other parts of the face, you can read more about causes and types of skin cancers in that section.
  • Sarcomas: These can also arise in the orbit and include rhabdomyosarcoma, osteosarcoma, chondrosarcoma, malignant fibrous histiocytome, hemangioperictyome, liposarcoma and angiosarcoma, to name a few.
  • Other very rare tumors such as malignant neurogenic tumors or peripheral nerve sheath tumors are possible; multiple myeloma, or even spread of cancers from another site, are possible as well.

Ocular (or eye) tumors themselves are usually diagnosed and treated by eye doctors. These can include retinoblastoma, conjunctival malignant melanoma, squamous carcinoma of the conjunctiva or melanoma of the uvea or choroid.

References

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13 Meldrum ML, Tse DT, Benedetto P. Neoadjuvant intracarotid chemotherapy for treatment of advanced adenocystic carcinoma of the lacrimal gland. Arch Ophthalmol. 1998;116:315-321.

14 Oberlin O, Rey A, Anderson J, Carli M, Raney RB, Treuner J, Stevens, MC. Treatment of orbital rhabdomyosarcoma: survival and late effects of treatment—results of an international workshop. Journal of clinical oncology. 2001;19(1),197-204.