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A Journal on Ophthalmology
Minerva Oftalmologica 2009 June;51(2):59-78
language: English, Italian
Orbital tumors: review of the literature and presentation of our experience
Amaddeo P., Fontana S.
Unit of Maxillofacial Surgery Bergamo Hospitals, Bergamo, Italy
Interesting orbital diseases, besides tumors, include malformations and inflammatory, traumatic, degenerative and dysthyroid diseases, whose incidence depends on factors such as genetic predisposition, sex, race and, especially, age. The two leading diseases in terms of incidence are inflammatory forms and cysts, while dysthyroid orbital disease ranks third, followed by vascular malformations, which rank first for prevalence in adolescents. Traumatisms come fifth, followed by tumors in the sixth place. Until the age of 20, hemangioma is the most frequent orbital disease that alone is the fourth overall cause in terms of incidence. In the 20-60 years of age group the disease is dominated by dysthyroid orbital disease (ca 60% of cases), followed by tumors. In patients aged over 60, dysthyroid orbital disease rank first for incidence, almost at the same level with tumors. Often orbital tumors are rather hard to diagnose as the clinical events triggered by both neoplastic and non-neoplastic diseases are often identical, numbering conjunctival hyperemia, diplopia, dystopia, exophthalmus, ptosis, etc.; hence, age is an important diagnostic factor. Primitive malignant orbital tumors have recorded an incidence of 2/ 1000000 until the sixth decade, which doubles in patients aged over 60, reaching ca 10/1000000 in those over 80. Dermoid cysts are the most common mass found in children (50% of orbital tumors in children), while cavernous hemangioma is typical in young adults. Lymphoid tumors comprise 3% of orbital tumors in children, 8% in the population at large and 28% in the elderly.