Łagodne guzy oczodołu u dzieci – obserwacje własne
Orbital Benign Tumors in Children – Own Observations
Anna Niwald, Mirosława Grałek, Beata Orawiec, Małgorzata Budzińska-Mikurenda, Andrzej Kapica
Klinika Okulistyki Dziecięcej Katedry Pediatrii Zabiegowej Uniwersytetu Medycznego w Łodzi
Samodzielny Publiczny Zespół Opieki Zdrowotnej, Uniwersytecki Szpital Kliniczny nr 4 Uniwersytetu Medycznego w Łodzi
Kierownik: dr hab. n. med. Anna Niwald
Summary: Introduction: A variety of benign tumors involve the orbit of the pediatric patients. These tumors may be apparent at birth or acquired later. Many are congenital with early presentation. Most pediatric orbital tumors are benign; developmental cysts comprise half of orbital cases, with vascular lesions such as capillary hemangioma being the second most common orbital tumors. Cysts consisting of squamous epithelium without adnexal structures are called epidermoids, cysts with dermal appendages are called dermoid cysts. Teratomas are rare congenital germ-cell tumors which arise from primordial germ cells. Macroscopically, same benign tumors as lipomas or fibrolipomas are poorly marginated. Benign tumors of orbit can cause eye motility disturbance. Visible deformity of the skin causes aesthetic problems.
Although many types of orbital neoplasm in children are benign tumors, malignancies tumors occurrence too. Ultrasonographic examination and especially computer tomography, and magnetic resonance imaging can help differentiate benign encapsulated tumors from solid tumors. A diagnostic open biopsy may be necessary in this cases. Complete surgical excision without cyst rupture is the standard care. Cyst wall rupture leads to severe inflammatory reaction in surrounding tissues. A non-encysted tumors deep penetrating in the orbit are excised in sight available. Diagnosis can be confirmed by histopathological examination. Purpose: Clinical and histopathological examination of orbital benign tumors in children subjected surgical treatment, based on own observations.
Material and Methods: 42 children (25 boys and 17 girls at the age from 2 months to 17 years) with benign orbital tumors were treated surgically due to progression or esthetic defect.
During the ophthalmological examiantion, there was no visual acuity reduction, anterior and posterior segment of the eye was normal. In all children ultrasound of the eye and orbit was performed and CT scan in 4 cases.
Results: There were orbital cysts – 36 tumors and 7 epibulbar tumors penetrating into orbit. Orbital cysts were localized predominantly in the temporal part of the orbit – 31 cases, mostly in upper temporal quadrant – 26 cases. 7 epibulbar tumors were placed in this region too. Under general anesthesia cysts were completely extirpated, epibulbar tumors were excised partially, in available of sight. Based on the histopathological examination dominated epidermalis cysts – 31 cases, and among non-encysted tumors were 4 fibrolipomas and 3 lipomas.
Conclusions: In our data benign orbital tumors in the children most commonly consist of epidermal cyst, epibulbar tumors are rare. Treatment consisted of surgical excision. The histopathological evaluation was necessary. Skin scars after surgery were cosmetic and hardly visible.
Słowa kluczowe: oczodół, guzy łagodne, torbiel naskórkowa, włókniakotłuszczak, tłuszczak, leczenie chirurgiczne, badanie histopatologiczne.
Keywords: orbit, benign tumors, epidermal cyst, fibrolipoma, lipoma, surgical treatment, histopathological examintation.