Orbital Tumour

medical based types and management
An orbital tumor refers to any tumor located in the “orbit,” which is the bony socket in the front of the skull that contains the eye

1. ORBITAL TUMO UR Prepared by Bobby A braham Submitted to S is.Jennitta SDU

2. An orbital tumor refers to any tumor 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 .

3. OVERVIEW The orbit is the cone-shaped bony socket that contains the eyeball.The orbital contents include the extra ocular muscles that move the eye, the optic nerve, the nerves and blood vessels supplying these structures and the fat inbetween . Tumors that develop in any of the tissues that surround the eyeball are referred to as orbital tum ors

4. TNM staging system TNM staging system One tool that doctors can use to describe the stage is the TNM system.Factors that go into determining the stage of the cancer in orbital tumour . T Characteristics of the main Tumor mass N Status of the lymph Nodes in the neck (i.e., evidence of cancer spread) M Metastasis Status of cancer spread to parts of the body outside of the head and neck

5. COMMON TYPES OF ORBITAL TUMOUR Rhabdomyosarcoma is the most common cancer of the orbit in children.

6. Retinoblastoma Retinoblastoma is the most common tumor inside the eyeball in children .

7. Neuroblastoma Neuroblastoma is the most common cancer to spread to the orbit in children

8. Dermoids and vascular lesions

9. Adult orbital tumors Lymphoma : This is the most common type of orbit tumor that starts 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 in the body.

10. Lacrimal gland cancers: 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 ( carcinosarcoma ) Adenocarcinoma Mucoepidermoid carcinoma

11. Lacrimal sac cancers Lacrimal sac cancers: These can include squamous cell carcinoma, adenocarcinoma, transitional cell carcinoma, salivary gland carcinoma and poorly differentiated carcinoma

12. Cancers of the skin of the eyelid 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

13. Sarcomas Sarcomas: These can also arise in the orbit and include rhabdomyosarcoma , osteosarcoma, chondrosarcoma , liposarcoma and angiosarcoma .

14. CAUSES OF ORBITAL TUMOUR The cause of primary orbital tumors is unknown. In children most orbital tumors result from developmental abnormalities. When visual loss or deterioration occurs with an orbital tumor, it may result from either mass effect, compromise of the vasculature to the optic apparatus as a result of the tumor, or invasion of the optic nerve by the tumor.

15. SYMPTOMS OF ORBITAL TUMOUR Many people with tumour don't have symptoms unless the tumour grows in certain parts of the eye or becomes more advanced. 1. Blurred vision. 2. Redness of the eye 3. Shadows, flashes of light 4. A dark patch in the eye that's getting bigger. 5. Partial or total loss of vision. 6. Bulging of one eye ,sudden proptosis 7. A lump on eyelid or in your eye that's increasing in size . 8. Pain in or around eye, although this is rare.

16. Diagnostic tests Diagnostic tests In addition to a physical examination, the following tests may be used to diagnose eye cancer: Eye examination . Most cases of melanoma are found during a regular eye examination. The doctor will examine the eye with a lighted instrument called an ophthalmoscope and a slit lamp, which is a microscope with a light attached to it.

17. Diagnostic tests. Ultrasound. An ultrasound uses sound waves to create a picture of the eye . Fluorescein angiography . This procedure takes a picture of the blood vessels in the eye. Fluorescein angiography may be used to rule out eye problems other than cancer Fine needle biopsy . This procedure removes tumor cells from the eye with a needle. This allows the doctor to look at the cells under a microscope.

18. Diagnostic tests Cytogenetics and gene expression profiling . Doctor's may recommend this type of test to help gather more information about your prognosis (chance of recovery) and treatment options. Cytogenetics or gene expression profiling tests are done using a tissue sample removed during either a biopsy or surgery. Computed tomography (CT) scan. A CT scan creates a three-dimensional picture of the inside of the body . it provides a detailed, cross-sectional view that shows any abnormalities or tumors.

19. Diagnostic tests Magnetic resonance imaging (MRI). An MRI uses magnetic fields to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein or given as a pill to swallow.

20. Diagnostic tests Positron emission tomography (PET) scan. The doctor may also order a positron emission tomography (PET) scan. A PET scan is a way to create pictures of organs and tissues inside the body. A small amount of a radioactive sugar substance is injected into a patient’s body. This sugar substance is taken up by cells that use the most energy. Because cancer tends to use energy actively, it absorbs more of the radioactive substance. A scanner then detects this substance to produce images of the inside of the body.

21. PROGNOSIS PROGNOSIS Surgical removal is curative for many orbital tumors and the cosmetic results can be excellent. The outcome and prognosis ultimately depends on the pathological diagnosis. Some orbital tumors may require additional therapy rather than biopsy or removal this may include conventional "external beam" or Gamma Knife Radiotherapy. Occasionally chemotherapy may also be necessary.

22. MEDICAL AND SURGICAL MANAGEMENT GOALS To prevent a malignancy from progressing to a life-threatening stage To preserve vision, and preserve the eye To alleviate the symptoms of an orbital tumor and restore the patient to good health

23. MEDICAL AND SURGICAL MANAGEMENT 1. Radiotherapy 2. Chemotherapy 3. Gamma Knife Radiosurgery 4. Surgical excision Surgical removal of the cancer is often the first line of treatment for head and neck cancers . Orbitotomy . A surgical incision made into the orbit to allow the removal of a tumour or foreign body, to treat a lesion, or to drain an abscess.

24. MEDICAL AND SURGICAL MANAGEMENT Evisceration Evisceration is the removal of the inside of the eyeball but not the outer layers. Exenteration Orbital exenteration is the removal of the entire eye socket, optic nerve and even bones surrounding the eye. Enucleation Enucleation is the removal of the eye but leaving the eye socket in place.

25. BIBLIOGRAPHY Brunner and Suddarth’s , “Medical Surgical Nursing ” Published by Lippincott, 10th edition. Lewis , Heitkemper and Dirksen’s , “Medical surgical nursing”, Published by Mosby, 6th edition. Head and neck cancer guide.com Nursesoutlook.blogspot.com American cancer journal