Orbital Tumors: Diagnosis and Treatment

From the Preface: “About every ten years a new book appears on any given medical specialty subject. Naturally, this is not because the entire body of knowledge on that specialty is overhauled every ten years but because the progress made over a decade usually warrants expressing new perspectives on quite a few diseases. Orbital oncology certainly qualifies as a subspecialty that merits an update every decade. At least two or three excellent textbooks on orbital tumors have been written since the mid-1980s. This book reports advances in knowledge about orbital diseases and their treatment and offers an up-to-date, single-volume reference for orbital tumors with particular emphasis on new improvements in diagnostic and therapeutic measures. Part I comprises advances in oncogenesis and its relationship to orbital tumors. Changes in the biological behavior of diseases in the general patient population are much slower than technological advances; nevertheless, those alterations take place as well. One of the major medical issues of our time, for example, is the changes in the immunological status of individuals. This issue influences the entire field of medicine, particularly oncology, including the treatment of orbital tumors. Chapters 2 to 5 summarize these influences. Medical genetics gained momentum during the past two decades and now affects the clinical practice of almost every discipline of medicine, including ophthalmology and orbitology. Chapters on principles of molecular genetics and immunosurveillance mechanisms of neoplasia and on the occurrence of multiplt, malignant neoplasms in retinoblastoma have been included to apply molecular concepts to clinical practice related to orbital tumors. Advances in one discipline often directly benefit practice in another field. In orbitology, no development has been more influential than the revolution in imaging techniques, including ultrasonography, computerized tomography, and magnetic resonance methods. Four chapters in Part II are devoted to the role of imaging in diganosis of orbital tumors. Other diagnostic advances entailing immunohistochemistry, flow cytometry, gene microarray, and the polymerase chain reaction are summarized in a separate chapter on orbital biopsy.” Table of Contents Cover Orbital Tumors Diagnosis And Treatment ISBN 038721321X Preface Acknowledgments Contents Contributors Part One Current Concepts Of Oncogenesis 1 Molecular Models Of Cancer Development Historical Overview Oncogenes Tumor Suppressor Genes Dna Mutations And Cancer New Perspectives On Dna Mutations Relevance Of Msi To Orbital Tumors Epigenomics: Dna Methylation And Histone Acetylation Do Mutations Matter In Cancer? 2 Immune Surveillance And Cancer Pathogenesis Immunological Response To Cancer Aging And Oncogenesis Viruses And Oncogenesis Ionizing Radiation, Chemicals, And Cancer Relevance Of Immunological Response To Orbital Tumors 3 The Changing Nature And Behavior Of Orbital And Periorbital Tumors Changes In The Incidence Of Orbital Diseases Over Time Immunosuppression And Cancer Immunosuppression And Infection Other Virus-associated Neoplasms Of The Orbit And Ocular Adnexa Conclusions 4 Mechanisms Of Tumor Metastasis In The Orbit Concept Of Metastasis Invasion And Metastasis Dissemination And Metastases The Metastasic Event In The Temporal Progression Of Cancer Tumor Cells And Stromal Interactions Gene Overexpression And Downregulation Orbital Metastasis Metastatic Disease In The Orbit Metastastic Disease From Primary Orbital Tumors Conclusions 5 Multiple Malignancies In Retinoblastoma Studies Of The Gene For Rb Types Of Second Malignancy Role Of Ebrt In Second Malignancies Management Of Second Malignancies Conclusions Part Two Diagnosis Of Orbital Tumors 6 Clinical Evaluation Of The Orbit History Ocular Examination Orbital Examination 7 Neuro-ophthalmologic Evaluation Of The Orbit History Examination Orbital Imaging Orbital Extension Of Intracranial Disease Systemic Disorders That May Affect The Orbit Conclusions 8 Ultrasonography In Orbital Differential Diagnosis Assessment Of Orbital Lesions Assessment Of Thickening Of Extraocular Muscles Optic Nerve Assessment Lacrimal Gland Lesions 9 The Basics Of Orbital Imaging Computed Tomography Magnetic Resonance Imaging Angiography And Orbital Interventions 10 Imaging In Orbital Differential Diagnosis Lesion Appearance Localization Contrast Enhancement Bone Evaluation Detection Of Calcification Radiological Differential Diagnosis Conclusions 11 New Concepts In Orbital Imaging A Diagnostic Paradigm State Of The Art Of Orbital Tumor Imaging New Developments In Imaging Conclusions 12 Orbital Biopsy Excisional Biopsy Incisional Biopsy Core Biopsy Fine-needle Aspiration Biopsy Intraoperative Biopsy (frozen Section) Sentinel Node Biopsy Methods Used In Tissue Diagnosis Part Three Primary Tumors Of The Orbit 13 Orbital Lymphoma Clinical Features Morphologic Features Classification Investigation Management 14 Vascular Tumors Cavernous Hemangioma Capillary Hemangioma Lymphangioma Orbital Varix Hemangiopericytoma Angiosarcoma Intravascular Papillary Endothelial Hyperplasia Arteriovenous Fistulas And Malformations Leiomyoma Angiolymphoid Hyperplasia With Eosinophilia And Kimura Disease 15 Fibrohistiocytic Tumors Fibromatoses Histiocytoses 16 Fibro-osseous And Cartilaginous Tumors And Tumorlike Conditions Bone-forming Lesions Cartilage-forming Lesions Fibro-osseous Lesions Fibrous Lesions Giant Cell-rich Lesions Cystic Lesions 17 Peripheral Nerve Tumors Schwannoma (neurilemoma) Neurofibroma Malignant Peripheral Nerve Sheath Tumor Granular Cell Tumor Alveolar Soft Part Sarcoma Paraganglioma Amputation Neuroma Melanotic Neuroectodermal Tumor Of Infancy Primary Orbital Neuroblastoma Primary Orbital Carcinoid Tumor Neurofibromatosis 18 Lacrimal Gland Tumors Dacryops (lacrimal Ductal Cysts) Pleomorphic Adenoma (benign Mixed Tumor) Malignant Mixed Tumor Adenoid Cystic Carcinoma Adenocarcinoma Mucoepidermoid Carcinoma Other Tumors 19 Tumors Of The Lacrimal Drainage System Differential Diagnosis Of Masses In The Lacrimal Sac Fossa Region Lacrimal Sac Tumor Presentation Investigation Management Of Lacrimal Sac Tumors (table 19.8) Conclusions Part Four Secondary Tumors Of The Adult Orbit 20 Eyelid And Periocular Skin Tumors Basal Cell Carcinoma Squamous Cell Carcinoma Sebaceous Gland Carcinoma Melanoma The Sydney Eye Hospital Experience Conclusions 21 Conjunctival Tumors Squamous Cell Carcinoma Conjunctival Melanoma 22 Ocular Tumors Retinoblastoma Choroidal Melanoma 23 Tumors Of The Cranial And Nasal Cavities And Paranasal Sinuses Secondary Orbital Tumors Originating From The Sinonasal Tract Secondary Orbital Tumors Originating From The Cranium 24 Metastatic Tumors Incidence And Epidemiology Clinical Findings Diagnostic Procedures Management And Prognosis Origins Of Metastases To Orbit Part Five Pediatric Orbital Tumors And Pseudotumors 25 Benign Pediatric Tumors Dermoid Dermolipoma Teratoma Mass Lesions Secondary To Orbitocranial Maldevelopments Congenital Cysts Other Cysts Primary Tumors 26 Malignant Pediatric Tumors Secondary And Metastatic Tumors Part Six Tumorlike Conditions In The Orbit 27 Orbital Inflammation And Infection Versus Neoplasia Inflammation Mimicking Neoplasia Neoplasia Mimicking Inflammation "malignant" Infections Conclusions 28 Graves Disease Pathogenesis Systemic Clinical Features Orbital Histopathology Orbital Clinical Features Radiologic Features Differential Diagnosis Management And Prognosis 29 Mass-forming Inflammatory Lesions Of The Orbit Infections Nonspecific Inflammations Specific Inflammations Part Seven Management Of Orbital Tumors 30 Staging Of Orbital Tumors 31 Surgical Treatment Preoperative Evaluation Surgical Planning And Preparation General Surgical Concepts Incision Correlation Of Surgical Procedures With Anatomy Surgical Procedures Wound Closure And Postoperative Care Complications 32 Computer Image Guidance And Skull-base Strategies Computer Image Guidance Techniques And Setup Why Use Image Guidance In Orbital Tumors? Image Fusion For Orbital Tumors Extended Craniotomy Approaches And The Orbit Radiosurgery Biopsies And Minimally Invasive Approaches Conclusions 33 Radiation Treatment Techniques Orbital Diseases Intraocular Tumors That Require Orbital Radiation Therapy Side Effects Of Orbital Radiation Therapy New Frontiers In Orbital Radiation Therapy Conclusions 34 Chemotherapy For Childhood Tumors Treatment Of Children Primary Malignant Orbital Tumors Malignant Tumors With Distant Orbit Metastases Malignant Tumors With Secondary Invasion Of The Orbit Nonmalignant Tumors Conclusions 35 Chemotherapy For Adult Tumors Inflammatory And Lymphoproliferative Disorders Primary Orbital Malignancy Secondary Orbital Malignancy Metastases Side Effects Of Chemotherapy Index