Orbital Cancer

Eyelid & Orbital Cancer Removal & Reconstruction

 

An orbital tumour refers to any a tumour located in the “orbit,” which is the bony socket in the front of the skull that contains the eye. The socket is a complicated structure that includes the eye itself along with muscles, nerves, and connective tissue.

The orbit is a complex structure that includes the eye itself along with muscles, nerves, and connective tissue.

orbital tumours

Cancer or a tumour begins when healthy cells change and grow uncontrollably, forming a mass called a tumour. A tumour can be benign or malignant.

  • Orbital tumours include retinoblastoma, carcinoma of the conjunctiva and melanoma of the conjunctiva or uvea, to name a few.

Eyelid and orbital cancers are do not only affect your sight but also can be life-threatening. Early management can save lives and provide good cosmetic and functional outcome.

Some orbital tumours occur most commonly in children, other types are more often diagnosed in adults.

The most common benign tumour of the orbit is:

Cavernous haemangioma

Which primarily develops in young or middle-aged adults. Fortunately, the tumours can be removed surgically and rarely recur once they are removed. Most orbital tumours in children are benign but need treatment to preserve vision.

An orbital tumour can be any one of a number of different tumour types, including:

  • Vascular tumours (e.g. hemangiomas, lymphangioma, hemangiopericytoma)
  • Lacrimal gland tumours (e.g. dacryoadenitis, benign mixed tumour, sarcoidosis and adenoid cystic carcinoma)
  • Growths that extend from the sinuses into the orbit (e.g. squamous carcinoma, mucocele)
  • Metastatic cancer can also come from other parts of the body to form an orbital tumour.
  • Inflammation (e.g. pseudotumor, sarcoidosis) or infection (abscess). 

Orbital cancer: Symptoms and Signs

People with orbital cancer may experience the following symptoms.

Sometimes people with eyelid cancer do not show any one of these symptoms. Or they may be caused by a medical condition that is not cancer-related.

  • Swelling of the eye
  • Thickening of the eyelid
  • An ulceration of the eyelid that does not heal
  • Spreading of coloured mass on eyelid
  • Sinus, pain and infections
  • Closed appearance of the eyelid
  • Bulging of the eyeball
  • Double vision (diplopia)
  • Change in vision
  • Redness in the eye

eyelid and orbital cancer example - bulging eyes


Treatments

Keep in mind that the treatment recommendation you receive may vary depending on the type of cancer you have.

Before starting treatment, I will complete a preoperative evaluation.

Preoperative Evaluation

  • A full history and physical examination
  • A biopsy to confirm a diagnosis of cancer
  • Imaging of the primary tumour and the neck
  • Maybe a PET-CT for advanced cancers
  • Preoperative medical clearance and optimization of medical conditions

Once I have gone through a pre-operative evaluation, I will recommend a course of treatment for you, depending on a number of factors.

Like for all cancers in the head and neck area, there are three general therapeutic options to consider:

  • Surgical removal(with or without reconstruction)
  • Radiation(a few different types)
  • Medications(chemotherapy and biologic medications)

When possible, orbital tumours are totally removed. If they cannot be removed or if removal will cause too much damage to the eye, a piece of tumour may be removed and sent for evaluation. Occasionally an orbital tumour is too big or involves the sinuses and requires more extensive surgery with bone-flaps.

Another option, if the tumour cannot be removed during surgery, is the use of external beam radiation therapy. If you have a rare orbital tumour sometimes it may require removal of the eye and orbital contents. In certain cases, orbital radiotherapy may be used to treat any residual tumour.

If you are concerned about one or more of the symptoms or sings, please make an appointment to see me. I will be able to ask you the relevant questions to help diagnose the cause of the problem.

Remember, Eyelid and orbital cancers are not only sight but also life-threatening. Early management can save lives and give good cosmetic and functional outcome.

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