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Guil-Ibáñez JJ, Gomar-Alba M, Castelló-Ruiz MJ, García-Pérez F, Narro-Donate JM, Vargas-López AJ, Masegosa-González J. Intraoperative ultrasound-assisted surgery in orbital apex tumours: technical note. J Ultrasound 2023; 26:733-741. [PMID: 36642754 PMCID: PMC10469155 DOI: 10.1007/s40477-022-00762-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/28/2022] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Since the introduction of ultrasonography (US) in the operating theatre in the early 1970s, intraoperative ultrasound (IOUS) has become a very useful tool for real-time neurosurgical procedures. The main limitation of US is its innately reduced capacity to penetrate the intact skull. This is the reason why most IOUS-assisted procedures are usually performed via transfontanellar or after a craniotomy or laminotomy is done. OBJECTIVE We present a 54-year-old woman with a right optic nerve sheath meningioma, who was operated on by a right cranio-orbital approach and IOUS-assisted tumour removal. METHODS Data concerning the anamnesis and complementary studies were obtained from the clinical history. Surgical images were obtained in the operating room during surgery. Images obtained by US were compared with the preoperative and postoperative imaging scans. IOUS imaging was also compared with the intraoperative findings. RESULTS The correlation between US and both preoperative and postoperative studies was very high. During surgery, both transpalpebral and transperiorbital IOUS facilitated the resection with no specific technical difficulties or significant time consumption. CONCLUSION Recent improvements in the image quality of IOUS devices offer several attractive options for real-time neuronavigation. We describe our initial experience with the IOUS-assisted technique for orbital apex tumours. In our patient transpalpebral and transperiorbital IOUS provided an excellent source of control over location and over the extent of tumour resection. We hope that this description of how we usually perform this procedure may be useful for some selected cases and contribute to the further enhancement and improvement of the technique.
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Affiliation(s)
- José Javier Guil-Ibáñez
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain.
| | - Mario Gomar-Alba
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
| | - María José Castelló-Ruiz
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
| | - Fernando García-Pérez
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
| | - José María Narro-Donate
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
| | - Antonio José Vargas-López
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
| | - José Masegosa-González
- Department of Neurosurgery, Hospital Universitario Torrecárdenas, Calle Hermandad Donantes de Sangre s/n, 04009, Almería, Spain
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Djuric ML, Krstic VP, Lazic TM, Grozdanic SD. Endoscopic diagnostic and surgical orbital approach in canines. Acta Vet Hung 2022. [PMID: 35895555 DOI: 10.1556/004.2022.00017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/31/2022] [Indexed: 02/18/2024]
Abstract
The aim of this study is to describe new diagnostic and surgical orbital approaches using video endoscopy in canines. Four different endoscopic approaches were investigated in this study of video endoscopy in cadavers: dorsal transorbital ligament approach via incision of the orbital ligament (DTOLA), dorsal subpalpebral transconjunctival approach (DSTA), ventral subpalpebral transconjunctival approach (VSTA), and transoral orbital approach (TOA). Two additional approaches, the ventral transpalpebral approach (VTA) and dorsal caudal transmuscular approach (DCTA) along with the DTOLA and DSTA were used in clinical patients. The most technically demanding approach was DTOLA; however, it provided the best visualisation of different anterior and posterior orbital structures. Visualisation of primarily the dorsal orbital wall, dorsal portion of the eye globe, and dorsal extraconal space also was achieved by DSTA. The VSTA enabled good visualisation of the ventral orbital floor and the ventral extraconal and intraconal space. In contrast, the TOA provided relatively poor visualisation of orbital structures, limited to the ventral orbital quadrant. Meanwhile, the VTA provided visualisation similar to the VSTA, while DCTA visualisation was limited to the dorsal and caudal orbital space. Orbital endoscopy is an effective and minimally invasive procedure that can be used for diagnostic and surgical orbital procedures.
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Affiliation(s)
- Milos Lj Djuric
- 1 Department of Equine, Small Animal, Poultry and Wild Animal Diseases, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia
| | - Vanja P Krstic
- 1 Department of Equine, Small Animal, Poultry and Wild Animal Diseases, Faculty of Veterinary Medicine, University of Belgrade, Belgrade, Serbia
| | - Tatjana M Lazic
- 2 Animal Eye Consultants of Iowa, Hiawatha, IA, USA
- 3 Oculus Specialty Veterinary Clinic, Belgrade, Serbia
| | - Sinisa D Grozdanic
- 2 Animal Eye Consultants of Iowa, Hiawatha, IA, USA
- 3 Oculus Specialty Veterinary Clinic, Belgrade, Serbia
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Alkatan H, Alyousef N, Alshabib N, J. Aljasser I. A comprehensive review of biopsy techniques for oculoplastic and orbital surgeons from ophthalmic pathologists' perspective. Saudi J Ophthalmol 2021. [DOI: 10.4103/sjopt.sjop_161_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Bata BM, Martin A, Connolly D, Mudhar HS, Hersey N, Salvi SM. Computerized Tomography-Guided Core-Needle Biopsy of Orbital Space-Occupying Lesions: A Case Series. Ocul Oncol Pathol 2020; 7:54-61. [PMID: 33796518 DOI: 10.1159/000510867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/12/2020] [Indexed: 02/01/2023] Open
Abstract
Purpose To describe our experience in performing biopsy of post-septal orbital masses with core needle under computerized tomography guidance (CT-CNB). Methods The medical records of all patients who underwent this procedure were reviewed. The procedure was performed under local anesthesia on a day case basis under a peribulbar block. A planning non-contrast computerized tomography (CT) scan of the orbits was performed to localise the mass. A 6-cm 18-G Temno Evolution® semi-automated biopsy needle was inserted through the skin into the orbit. Prior to further advancement of the needle, a low-dose CT limited to the previously determined plane was performed to confirm its position. The needle was then advanced, and the cutting needle was deployed to obtain the biopsy. Results Five patients who underwent CT-CNB were identified. The CNB was successful in 4 patients and revealed a metastatic prostate adenocarcinoma, diffuse large B-cell lymphoma, a metastatic neuroendocrine tumour, and orbital inflammatory disease. The biopsy failed in the fifth patient when the needle failed to penetrate the tumour despite good localisation on CT. He was eventually diagnosed with fibrous meningioma of the greater wing of sphenoid on open biopsy. None of the patients had any complications other than peri-ocular bruising which was present in all of them. Conclusion CT-CNB of mass lesions located in the lateral aspect of the orbit can be an alternative to open biopsy in selected cases. It avoids major surgery and allows the use of radiotherapy, if required, without any delay.
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Affiliation(s)
- Bashar M Bata
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Andrew Martin
- Department of Radiology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Daniel Connolly
- Department of Radiology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Hardeep Singh Mudhar
- National Specialist Ophthalmic Pathology Service (NSOPS) Department of Histopathology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Naomi Hersey
- Department of Radiology, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Sachin M Salvi
- Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom
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Cruzado-Sánchez D, Sánchez-Ortiz J, Peralta CI, Tellez WA, Maquera-Torres G, Serpa-Frías S. Orbital metastasis diagnosed by ultrasound-guided fine-needle aspiration biopsy: Case report of unknown primary site. ACTA ACUST UNITED AC 2019; 94:566-570. [PMID: 31378389 DOI: 10.1016/j.oftal.2019.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/01/2019] [Accepted: 07/02/2019] [Indexed: 11/25/2022]
Abstract
Twenty five percent of orbital metastasis is usually of unknown primary origin and it requires histopathological and immunohistochemical confirmation. The fine-needle aspiration biopsy of the orbit is an alternative procedure to conventional orbitotomy. The case is presented of a 60 year-old woman with a right orbit tumour mass and neoplastic lesions in her brain and cranium. As an incidental finding, she had a thrombus in her left atrium, and so an orbitotomy procedure was ruled out. An ultrasound-guided fine-needle aspiration biopsy was performed instead with rapid on-site evaluation of biopsy samples. These showed malignant cells of a lung adenocarcinoma, which was confirmed with immunohistochemistry and chest diagnostic images. In conclusion, biopsy samples obtained by fine-needle aspiration biopsy, together with cytopathological and immunohistological analysis, enabled orbital metastasis to be identified in the case described, and showed that fine-needle aspiration biopsy is a safe, effective, and minimally invasive alternative.
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Affiliation(s)
- D Cruzado-Sánchez
- Servicio de Oncología Ocular, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú.
| | - J Sánchez-Ortiz
- Servicio de Oftalmología, Hospital Nacional Cayetano Heredia, Lima, Perú
| | - C I Peralta
- Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Universidad Nacional Federico Villarreal, Lima, Perú
| | - W A Tellez
- Sociedad Científica de Estudiantes de Medicina Villarrealinos (SOCEMVI), Universidad Nacional Federico Villarreal, Lima, Perú
| | - G Maquera-Torres
- Servicio de Patología, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú
| | - S Serpa-Frías
- Servicio de Oncología Ocular, Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Perú
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Timmis A, Touska P, Uddin J, Pilcher J. The role of ultrasound-guided tissue sampling techniques in the management of extra-ocular orbital lesions. ULTRASOUND : JOURNAL OF THE BRITISH MEDICAL ULTRASOUND SOCIETY 2018; 26:145-152. [PMID: 30147738 DOI: 10.1177/1742271x18759824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 12/07/2017] [Indexed: 11/15/2022]
Abstract
Background Multiple disease processes may arise within the orbit and imaging plays a vital role in the evaluation of such lesions. The anterior orbital contents are readily amenable to evaluation by ultrasonography. Furthermore, the modality can be used to guide tissue sampling (fine needle aspiration or core biopsy) and may obviate the requirement for invasive surgical biopsy. Methods We carried out a retrospective review of ultrasound-guided fine needle aspirations/core biopsies of extra-ocular orbital lesions undertaken at our institution. The anatomical locations, sonographic appearances and sampling techniques were analysed. Results There were 7 fine needle aspirations and 1 core biopsy carried out during the period analysed. Multimodality imaging was available in all cases. The majority of lesions were located in the region of the lacrimal gland. All procedures were well-tolerated and there were no post-procedure complications. Conclusion Many extra-ocular, orbital neoplasms are amenable to ultrasound-guided tissue sampling and the procedure is well tolerated. However, a clear understanding of orbital anatomy, differential diagnosis and technique is required to enable safe sampling. Furthermore, a collaborative, multimodality approach is imperative for optimal patient management.
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Affiliation(s)
- Antonia Timmis
- Department of Clinical Radiology, St George's University Hospitals NHS Foundation Trust, UK
| | - Philip Touska
- Department of Clinical Radiology, St George's University Hospitals NHS Foundation Trust, UK
| | | | - James Pilcher
- Department of Clinical Radiology, St George's University Hospitals NHS Foundation Trust, UK
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Diagnostic Approaches to Metastatic Hepatocellular Carcinoma of the Orbit. Ophthalmic Plast Reconstr Surg 2017; 33:S129-S131. [DOI: 10.1097/iop.0000000000000641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Briscoe D, Safieh C, Ton Y, Shapiro H, Assia EI, Kidron D. Characteristics of orbital lymphoma: a clinicopathological study of 26 cases. Int Ophthalmol 2017; 38:271-277. [PMID: 28364339 DOI: 10.1007/s10792-017-0457-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 01/24/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Evaluation of the medical data of patients with orbital and adnexal lymphoma. DESIGN Cohort study of all cases diagnosed with orbital or adnexal lymphoma at Meir Medical Center between 1993 and 2007. PARTICIPANTS Twenty-six patients, with intraorbital or subconjunctival masses with orbital involvement, were examined and followed up between 1 and 8 years. MATERIALS AND METHODS Examined data included: clinical presentation, age, gender, imaging, tumor location, surgical management, and pathological diagnosis. RESULTS Presenting signs and symptoms included proptosis, eyelid lesions, tearing, chemosis, decreased visual acuity, ptosis, pain, squint, and optic nerve compression. In five cases, lymphoma was misdiagnosed on neuroimaging. Bone changes were seen in four patients. All cases were B cell lymphomas; with the majority (22 cases) of small B cell type; consisting of primary extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and two cases of small cell lymphoma. One small cell lymphomas was of follicular type on a background of CLL, and the other was CLL/SLL type. Fourteen cases were primary orbital disease, and 12 cases were systemic disease. Macroscopic appearance of lymphoma at open biopsy was characteristic in most cases. Flow cytometry phenotyping gave rapid reliable diagnosis of the disease. CONCLUSIONS Epiphora or chemosis in the presence of an orbital mass should alert the ophthalmologist to suspect lymphoma. Lymphoma may be easily misinterpreted on neuroimaging for other diseases. Bone changes seen on CT are more common than is generally perceived. Macroscopic appearance at open biopsy was characteristic.
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Affiliation(s)
- Daniel Briscoe
- Department of Ophthalmology, Technion Faculty of Medicine, Emek Medical Center, Afula, Israel. .,Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel.
| | - Christine Safieh
- Department of Ophthalmology, Technion Faculty of Medicine, Emek Medical Center, Afula, Israel.,Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Yokrat Ton
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Hava Shapiro
- Department of Haematocytology, Meir Medical Center, Kfar Saba, Israel
| | - Ehud I Assia
- Department of Ophthalmology, Meir Medical Center, Kfar Saba, Israel
| | - Dvora Kidron
- Department of Pathology, Meir Medical Center, Kfar Saba, Israel
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Edalat F, Cazzato RL, Garnon J, Tsoumakidou G, Avérous G, Caudrelier J, Koch G, Gangi A. Percutaneous Biopsy of Retrobulbar Masses: Anatomical Considerations and MRI Guidance. Cardiovasc Intervent Radiol 2016; 40:591-595. [DOI: 10.1007/s00270-016-1523-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 12/01/2016] [Indexed: 10/20/2022]
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10
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Kanavi MR. Fine Needle Aspiration Cytology of Orbital and Ocular Adnexal Lesions. J Ophthalmic Vis Res 2016; 11:243-4. [PMID: 27621778 PMCID: PMC5000523 DOI: 10.4103/2008-322x.188391] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cirla A, Rondena M, Bertolini G. Automated tru-cut imaging-guided core needle biopsy of canine orbital neoplasia. A prospective feasibility study. Open Vet J 2016; 6:114-20. [PMID: 27540512 PMCID: PMC4980476 DOI: 10.4314/ovj.v6i2.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Accepted: 06/25/2016] [Indexed: 12/21/2022] Open
Abstract
The purpose of this study was to evaluate the diagnostic value of imaging-guided core needle biopsy for canine orbital mass diagnosis. A second excisional biopsy obtained during surgery or necropsy was used as the reference standard. A prospective feasibility study was conducted in 23 canine orbital masses at a single centre. A complete ophthalmic examination was always followed by orbital ultrasound and computed tomography (CT) examination of the head. All masses were sampled with the patient still on the CT table using ultrasound (US) guided automatic tru-cut device. The most suitable sampling approach to the orbit was chosen each time based on the CT image analysis. One of the following different approaches was used: trans-orbital, trans-conjunctival or trans-masseteric. In all cases, the imaging-guided biopsy provided a sufficient amount of tissue for the histopathological diagnosis, which concurred with the biopsies obtained using the excisional technique. CT examination was essential for morphological diagnosis and provided detailed topographic information that allowed us to choose the safest orbital approach for the biopsy. US guided automatic tru-cut biopsy based on CT images, performed with patient still on the CT table, resulted in a minimally invasive, relatively easy, and accurate diagnostic procedure in dogs with orbital masses.
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Affiliation(s)
- A Cirla
- San Marco Veterinary Laboratory, via Sorio 114/c - 35141 Padova, Italy
| | - M Rondena
- San Marco Veterinary Laboratory, via Sorio 114/c - 35141 Padova, Italy
| | - G Bertolini
- San Marco Veterinary Clinic, via Sorio 114/c - 35141 Padova, Italy
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Jeng Tyng C, Matushita JPK, Bitencourt AGV, Neves FBCS, Amoedo MK, Barbosa PNV, Chojniak R. Uncommon primary tumors of the orbit diagnosed by computed tomography-guided core needle biopsy: report of two cases. Radiol Bras 2015; 47:380-3. [PMID: 25741122 PMCID: PMC4341380 DOI: 10.1590/0100-3984.2013.1888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Accepted: 01/17/2014] [Indexed: 02/08/2023] Open
Abstract
Computed tomography-guided percutaneous biopsy is a safe and effective alternative
method for evaluating selected intra-orbital lesions where the preoperative diagnosis
is important for the therapeutic planning. The authors describe two cases of patients
with uncommon primary orbital tumors whose diagnosis was obtained by means of
computed tomography-guided core needle biopsy, with emphasis on the technical aspects
of the procedure.
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Affiliation(s)
- Chiang Jeng Tyng
- Master, Titular Physician and Responsible for the Unit of Percutaneous Intervention, Imaging Department at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | | | | | | | | | - Paula Nicole Vieira Barbosa
- Master, Titular Physician and Responsible for the Unit of Computed Tomography, Imaging Department at A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Rubens Chojniak
- PhD, Titular Physician and Director, Department of Imaging, A.C.Camargo Cancer Center, São Paulo, SP, Brazil
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Nair LK, Sankar S. Role of fine needle aspiration cytology in the diagnosis of orbital masses: A study of 41 cases. J Cytol 2014; 31:87-90. [PMID: 25210236 PMCID: PMC4159903 DOI: 10.4103/0970-9371.138672] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Complexity in the anatomy of orbit and the fear of globe rupture are the main challenges faced in the diagnosis and typing of orbital masses. Fine needle aspiration cytology can be used as an initial investigative procedure in the evaluation of orbital masses, which in turn can aid the clinician to plan the treatment modalities. A close cooperation between ophthalmologist and pathologist adds to the success of the procedure. AIM The study was conducted in an attempt to evaluate the role of fine needle aspiration cytology (FNAC) in the diagnosis of orbital lesions as a cost-effective diagnostic technique, and to assess its diagnostic efficacy by comparing it with histopathological diagnosis. MATERIALS AND METHODS The study was conducted on 50 patients, over a period of 3 years, who had presented with anterior orbital mass lesions with or without proptosis, and with those having accessible mass lesions. Patients with proptosis without anterior orbital masses, proptosis due to dysthyroid ophthalmopathy, arteriovenous fistulas, hamartomas and choristomas were excluded from the study. FNAC procedure was done after explaining about the procedure to the patient, and in the presence of an ophthalmologist. RESULTS Majority of patients belonged to the age group 50-59 years. Male: female ratio was 1.05: 1. The most common lesion on FNAC was non-Hodgkins lymphoma, [13 cases (31.7%)]. 11 (26.8%) cases out of this were confirmed to be non-Hodgkins lymphoma on histopathologic examination. Two cases turned out to be inflammatory pseudotumor. CONCLUSIONS FNAC can be done in all palpable orbital mass lesions with minimal risk and complications, with close cooperation between ophthalmologist and pathologist. A good degree of correlation was obtained between FNAC and histopathology, which was assessed by kappa statistics.
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Affiliation(s)
- Lekha Krishnan Nair
- Department of Pathology, Government Medical College, Thiruvananthapuram, Kerala, India
| | - S Sankar
- Department of Pathology, Government Medical College, Thiruvananthapuram, Kerala, India
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Yarovoy AA, Bulgakova ES, Shatskikh AV, Uzunyan DG, Kleyankina SS, Golubeva OV. CORE needle biopsy of orbital tumors. Graefes Arch Clin Exp Ophthalmol 2013; 251:2057-61. [PMID: 23515750 DOI: 10.1007/s00417-013-2315-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 03/01/2013] [Accepted: 03/06/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND In some orbital mass lesions, histology may be the only way to establish an accurate diagnosis. Core needle biopsy (CNB) is widely performed in oncology, and unlike fine needle aspiration biopsy (FNAB), it can provide sufficient tissue sample for histology and immunohistochemistry. The purpose of this study was to evaluate the usefulness and possible complications of CNB of orbital tumors. METHODS Fifty orbital lesions from 46 patients (age: 2-84 years) were biopsied using 20-gauge and 18-gauge semi-automated needles; 11 procedures were performed under ultrasound guidance. All 50 samples received routine histopathological examination and immunohistochemical analysis. RESULTS Specimens diagnostically sufficient for histological analysis were obtained in all biopsies. The histopathological diagnosis was established in 94% of specimens: 30 tumors were malignant: lymphoma (20); rhabdomyosarcoma (six); lacrimal gland carcinoma (one); breast carcinoma metastasis (two); melanoma (one); three were benign; ten inflammatory; and four were orbital fibrosis. Three biopsies were nondiagnostic: two (lymphoma, angiofibroma) showed undetermined identification and one was a false-negative (lacrimal gland adenocarcinoma was misdiagnosed as fibrous tissue). The diagnoses were confirmed by excisional or incisional biopsy in 26 patients. The concordance rate in patients with a surgically confirmed diagnosis was 88%. The sensitivity, specificity and accuracy for differentiating malignant from benign lesions were 94%, 100%, and 96%, respectively. Two patients suffered complications: mild retrobulbar hematoma with no decreased visual acuity. There was no damage to the globe or optic nerve, motility disorder, or infection. CONCLUSIONS CNB of orbital mass lesions is a safe procedure that provides a sufficient amount of tissue for histology and immunohistochemistry, and may be useful for improving the quality of the pathological diagnosis of orbital tumors.
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Affiliation(s)
- Andrey A Yarovoy
- Ocular Oncology Department, The S. Fyodorov Eye Microsurgery Federal State Institution, Beskudnikovsky blvd., 59A, 127486 Moscow, Russia.
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Agrawal P, Dey P, Lal A. Fine-needle aspiration cytology of orbital and eyelid lesions. Diagn Cytopathol 2013; 41:1000-11. [PMID: 23457033 DOI: 10.1002/dc.22972] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 01/01/2013] [Indexed: 11/12/2022]
Abstract
Fine-needle aspiration cytology (FNAC) of orbital lesions is now increasingly popular. Because of its unique location and the occurrence of varieties of lesions, diagnosis of orbital lesion is a challenge to the cytopathologists. FNAC of orbital and eyelid tumors is a suitable diagnostic technique that necessitates close co-operation between the ophthalmologist and pathologist. No radical procedure should be planned on the basis of FNAC, but it allows the diagnosis of a new primary lesion or the recurrence or metastasis of a tumor and can be done to identify lesions that require either specific medical therapy, as in nonresectable, inflammatory, and lymphoid tumors, or limited surgery for benign resectable neoplasms. With the help of various ancillary techniques a definitive diagnosis is possible on orbital and adnexal lesions. It is essential to have a detailed knowledge on the FNAC of these lesions and their potential pitfalls. In this present review, we have discussed various orbital lesions, their clinical presentations, cytomorphology, and ancillary techniques to confirm the diagnosis.
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Affiliation(s)
- Pallavi Agrawal
- Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Orlandi D, Sconfienza LM, Lacelli F, Bertolotto M, Sola S, Mauri G, Savarino E, Serafini G. Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Eur Radiol 2013; 23:1919-24. [DOI: 10.1007/s00330-013-2776-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 12/15/2012] [Accepted: 12/19/2012] [Indexed: 12/26/2022]
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17
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Singhal N, Mundi IK, Handa U, Punia RPS, Mohan H. FNA in diagnosis of orbital lesions causing proptosis in adults. Diagn Cytopathol 2011; 40:861-4. [PMID: 21485026 DOI: 10.1002/dc.21649] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 12/09/2010] [Indexed: 11/10/2022]
Affiliation(s)
- Niti Singhal
- Department of Pathology, Government Medical College & Hospital, Sector-32 B, Chandigarh 160040, India.
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Boroffka SAEB, Verbruggen AM, Grinwis GCM, Voorhout G, Barthez PY. Assessment of ultrasonography and computed tomography for the evaluation of unilateral orbital disease in dogs. J Am Vet Med Assoc 2007; 230:671-80. [PMID: 17331049 DOI: 10.2460/javma.230.5.671] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe clinical, ultrasonographic, and computed tomographic (CT) features of confirmed neoplastic and nonneoplastic disease in dogs with unilateral orbital diseases, determine criteria to differentiate between the 2 conditions, and assess the relative value of ultrasonography and CT for the differential diagnosis of these 2 conditions. DESIGN Prospective study. ANIMALS 29 dogs with unilateral neoplastic orbital disease and 16 dogs with unilateral nonneoplastic orbital disease. PROCEDURES Clinical history and results of physical and ophthalmologic examinations were recorded. Ultrasonographic and CT images were evaluated, and discriminating factors were identified to differentiate neoplastic from nonneoplastic diseases. Diagnostic value of ultrasonography and CT was assessed. RESULTS Dogs with neoplastic disease were significantly older; had clinical signs for a longer time before initial examination; had more progressive onset of clinical signs; and more frequently had protrusion of the nictitating membrane, fever, and anorexia. The most discriminating factor for both imaging modalities was delineation of the margins (odds ratio was 41.7 for ultrasonography and 45 for CT), with neoplastic lesions clearly delineated more often. Ultrasonographically, neoplastic lesions were more frequently hypoechoic and homogeneous, with indentation of the globe and bone involvement evident more frequently than for nonneoplastic lesions. Mineralization was detected only with neoplasia. Fluctuant fluid was seen more frequently in dogs with nonneoplastic disease. Computed tomography more frequently revealed extraorbital involvement. Diagnostic value was similar for both imaging modalities. CONCLUSIONS AND CLINICAL RELEVANCE Ultrasonography and CT are valuable imaging modalities to assist in differentiating neoplastic from nonneoplastic unilateral orbital disease in dogs.
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Affiliation(s)
- Susanne A E B Boroffka
- Division of Diagnostic Imaging, Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3508 TD, Utrecht, The Netherlands
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Browning MB, Camitta BM. The surgeon's role in pediatric orbital malignancies: an oncologist's perspective. Ophthalmic Plast Reconstr Surg 2003; 19:340-4. [PMID: 14506417 DOI: 10.1097/01.iop.0000087072.85558.90] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Meghen B Browning
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee 53226, USA
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Gorospe L, Royo A, Berrocal T, García-Raya P, Moreno P, Abelairas J. Imaging of orbital disorders in pediatric patients. Eur Radiol 2003; 13:2012-26. [PMID: 12942303 DOI: 10.1007/s00330-002-1738-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2002] [Revised: 07/24/2002] [Accepted: 10/01/2002] [Indexed: 10/26/2022]
Abstract
The spectrum of orbital lesions occurring in childhood is wide, including a variety of both benign and malignant disorders. Although physical examination and fundoscopy may aid in establishing the diagnosis of retro-ocular lesions, imaging remains a critical step in the evaluation of the pediatric orbit. Ultrasonography, CT, and MR imaging are the primary modalities for the evaluation of the diseased orbit, and careful observation of the characteristic radiological features usually leads to correct diagnosis; however, some of the lesions look very similar and are difficult to differentiate from each other. The purpose of this article is to review the common and unusual entities that may involve the pediatric orbit, to describe the radiological features, and to evaluate the efficacy of US, CT, and MRI in the diagnosis and management of these conditions.
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Affiliation(s)
- Luis Gorospe
- Department of Radiology, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain.
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Zaharopoulos P, Schnadig V. Vitreous cytology in asteroid hyalosis and observations on interpretation of cytologic findings in specimens of the posterior (vitreous) compartment of the eye. Diagn Cytopathol 2003; 28:88-91. [PMID: 12561028 DOI: 10.1002/dc.10236] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Cytologic methods have been used in the pathologic investigation of the posterior (vitreous) compartment of the eye in specimens obtained by fine-needle aspiration, as well as by surgical procedures. The vitreous body, which is in a semiliquid gel state, lends itself to pathologic investigation by cytologic methods. We report on a case of reparative eye surgery for complications of previous cataract extraction; vitrectomy was performed for vitreous opacities, which, by cytologic examination, were diagnostic of asteroid hyalosis, a relatively uncommon condition affecting the elderly. The cytologic findings diagnostic of this disease are described. Observations are made on the cytologic findings commonly encountered in specimens obtained from the posterior (vitreous) compartment of the eye.
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Affiliation(s)
- Paul Zaharopoulos
- Department of Pathology, University of Texas Medical Branch, Galveston, Texas 77555, USA.
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