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Myths in the Diagnosis and Management of Orbital Tumors.

Gündüz K, Yanık Ö - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Bottom Line: Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future.This will enable targeted treatments even for diseases with the same histopathologic diagnosis.Phenotypic variability within the same disease will be addressed using targeted treatments.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

ABSTRACT
Orbital tumors constitute a group of diverse lesions with a low incidence in the population. Tumors affecting the eye and ocular adnexa may also secondarily invade the orbit. Lack of accumulation of a sufficient number of cases with a specific diagnosis at various orbital centers, the paucity of prospective randomized studies, animal model studies, tissue bank, and genetic studies led to the development of various myths regarding the diagnosis and treatment of orbital lesions in the past. These myths continue to influence the diagnosis and treatment of orbital lesions by orbital specialists. This manuscript discusses some of the more common myths through case summaries and a review of the literature. Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future. This will enable targeted treatments even for diseases with the same histopathologic diagnosis. Phenotypic variability within the same disease will be addressed using targeted treatments.

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Related in: MedlinePlus

A 42-year-old female presenting with painful proptosis. (a) T1-weighted axial magnetic resonance imaging shows ill-defined orbital lesion occupying the apex. The lesion is isointense to the cerebral gray matter and extraocular muscle. (b) The apical lesion shows marked contrast enhancement after gadolinium injection. (c) T2-weighted axial magnetic resonance imaging demonstrates that lesion is hypointense to the cerebral gray matter and extraocular muscle
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Figure 1: A 42-year-old female presenting with painful proptosis. (a) T1-weighted axial magnetic resonance imaging shows ill-defined orbital lesion occupying the apex. The lesion is isointense to the cerebral gray matter and extraocular muscle. (b) The apical lesion shows marked contrast enhancement after gadolinium injection. (c) T2-weighted axial magnetic resonance imaging demonstrates that lesion is hypointense to the cerebral gray matter and extraocular muscle

Mentions: A 43-year-old female presented with pain, proptosis, and decreased vision in the right eye. Orbital MRI demonstrated an ill-defined mass located in the right orbital apex isointense to the extraocular muscles on T1W images [Figure 1a], hyopintense on T2W images [Figure 1b] with moderate contrast enhancement [Figure 1c]. At this point, the MRI findings were consistent with either an inflammatory mass or a nonepithelial tumor such as lymphoma.1 Although some studies suggested that diffusion weighted images can be used to differentiate between these two disease conditions, there is still a considerable overlap between them.


Myths in the Diagnosis and Management of Orbital Tumors.

Gündüz K, Yanık Ö - Middle East Afr J Ophthalmol (2015 Oct-Dec)

A 42-year-old female presenting with painful proptosis. (a) T1-weighted axial magnetic resonance imaging shows ill-defined orbital lesion occupying the apex. The lesion is isointense to the cerebral gray matter and extraocular muscle. (b) The apical lesion shows marked contrast enhancement after gadolinium injection. (c) T2-weighted axial magnetic resonance imaging demonstrates that lesion is hypointense to the cerebral gray matter and extraocular muscle
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660525&req=5

Figure 1: A 42-year-old female presenting with painful proptosis. (a) T1-weighted axial magnetic resonance imaging shows ill-defined orbital lesion occupying the apex. The lesion is isointense to the cerebral gray matter and extraocular muscle. (b) The apical lesion shows marked contrast enhancement after gadolinium injection. (c) T2-weighted axial magnetic resonance imaging demonstrates that lesion is hypointense to the cerebral gray matter and extraocular muscle
Mentions: A 43-year-old female presented with pain, proptosis, and decreased vision in the right eye. Orbital MRI demonstrated an ill-defined mass located in the right orbital apex isointense to the extraocular muscles on T1W images [Figure 1a], hyopintense on T2W images [Figure 1b] with moderate contrast enhancement [Figure 1c]. At this point, the MRI findings were consistent with either an inflammatory mass or a nonepithelial tumor such as lymphoma.1 Although some studies suggested that diffusion weighted images can be used to differentiate between these two disease conditions, there is still a considerable overlap between them.

Bottom Line: Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future.This will enable targeted treatments even for diseases with the same histopathologic diagnosis.Phenotypic variability within the same disease will be addressed using targeted treatments.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.

ABSTRACT
Orbital tumors constitute a group of diverse lesions with a low incidence in the population. Tumors affecting the eye and ocular adnexa may also secondarily invade the orbit. Lack of accumulation of a sufficient number of cases with a specific diagnosis at various orbital centers, the paucity of prospective randomized studies, animal model studies, tissue bank, and genetic studies led to the development of various myths regarding the diagnosis and treatment of orbital lesions in the past. These myths continue to influence the diagnosis and treatment of orbital lesions by orbital specialists. This manuscript discusses some of the more common myths through case summaries and a review of the literature. Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future. This will enable targeted treatments even for diseases with the same histopathologic diagnosis. Phenotypic variability within the same disease will be addressed using targeted treatments.

Show MeSH
Related in: MedlinePlus