Maligne Neoplasien der Orbita

Zusammenfassung

Weil die Erstsymptomatik maligner Neoplasien der Orbita häufig das Auge betrifft (Exophthalmus, Diplopie, Schmerzen), ist der Augenarzt häufig der erste mit der Problematik des jeweiligen Krankheitsbildes konfrontierte Arzt, von dessen Kenntnissen, richtiger Einordnung und richtigen weiteren Entscheidungen die adäquate weitere Therapiesteuerung und die Prognose des Patienten entscheidend abhängen.

Abstract

Malignant masses of the orbit include a large variety of neoplasms of epithelial or mesenchymal origin. The treatment of orbital malignancies is an essential interdisciplinary field of medicine that integrates ENT medicine, facial surgery, plastic surgery, neurosurgery, oncology and radiology.

The main symptom of malignant orbital masses is the exophthalmos. A symptom that can help to differentiate a benign from a malignant orbital mass can be the pain. The main diagnostic tool is the MRI including new sequences like DWI and DCE.

After presenting symptoms and diagnostic strategies of malignant orbital masses, this article starts with the description of malignant epithelial neoplasms of the lacrimal gland. Furthermore, it describes new insights in orbital lymphomas, followed by the discussion of semimalignant orbital masses. Last but not least the text deals with malignant neoplasms of the skin that can grow secondarily in the orbit. Finally, the manuscript discusses orbital metastases.

• Literatur

• 1 Von Sonnleithner C, Zorn M, Bertelmann E. Benigne Neoplasien der Orbita. Augenheilkunde up2date 2019; 9: 119-137
• 2 Welkoborsky HJ, Wiechens B, Hinni ML. Orbita: Interdisziplinäres Management von Orbitaerkrankungen. Stuttgart, New York: Thieme; 2016
• 3 Ro SR, Asbach P, Siebert E. et al. Characterization of orbital masses by multiparametric MRI. Eur J Radiol 2016; 85: 324-336
• 4 Erb-Eigner K, Asbach P, Ro SR. et al. DCE-MR imaging of orbital lesions: diagnostic performance of the tumor flow residence time τ calculated by a multi-compartmental pharmacokinetic tumor model based on individual factors. Acta Radiol 2019; 60: 643-652
• 5 Shields JA, Shields C, Scartozzi R. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology 2004; 111: 997-1008
• 6 Tellado MV, McLean IW, Specht CS. et al. Adenoid cystic carcinomas of the lacrimal gland in childhood and adolescence. Ophthalmology 1997; 104: 1622-1625
• 7 Shields JA, Shields CL. Eyelid, conjunctival, and orbital Tumors: Atlas and Textbook. 2nd ed.. ed. Philadelphia: Lippincott Williams & Wilkins; 2008
• 8 Duke TG, Fahy GT, Brown LJ. Adenoid cystic carcinoma of the superonasal conjunctival fornix. Orbit 2000; 19: 31-35
• 9 Font RL, Del Valle M, Avedaño J. et al. Primary adenoid cystic carcinoma of the conjunctiva arising from the accessory lacrimal glands: a clinicopathologic study of three cases. Cornea 2008; 27: 494-497
• 10 Font RL, Smith SL, Bryan RG. Malignant epithelial tumors of the lacrimal gland: a clinicopathologic study of 21 cases. Arch Ophthalmol 1998; 116: 613-616
• 11 Bartley GB, Harris GJ. Adenoid cystic carcinoma of the lacrimal gland: is there a cure…yet?. Ophthalmic Plast Reconstr Surg 2002; 18: 315-318
• 12 Goto H, Yamakawa N, Komatsu H. et al. Clinico-epidemiological analysis of 1000 cases of orbital tumors. Jpn J Ophthalmol 2021; 65: 704-723
• 13 Henderson JW, Farrow GM. Primary malignant mixed tumors of the lacrimal gland. Report of 10 cases. Ophthalmology 1980; 87: 466-475
• 14 White VA. Understanding and classification of ocular lymphomas. Ocul Oncol Pathol 2019; 5: 379-386
• 15 Zschoche M, Emmert S, von Bubnoff N. et al. Augenbefall und Systemerkrankung – periokuläre und intraokuläre Lymphome. Onkologe 2020; 26: 1056-1064
• 16 Olsen TG, Heegaard S. Orbital lymphoma. Surv Ophthalmol 2019; 64: 45-66
• 17 Gutmann M, von Sonnleithner C. et al. Unclear orbital mass. Ophthalmologe 2023; 120: 200-204
• 18 Stout AP, Murray MR. Hemangiopericytoma: a vascular tumor featuring Zimmermannʼs pericytes. Ann Surg 1942; 116: 26-33
• 19 De Bernardi A, Dufresne A, Mishellany F. et al. Novel therapeutics options for solitary fibrous tumor: antiangiogenic therapy and beyond. Cancers 2022; 14: 1064
• 20 Georgiesh T, Namløs HM, Sharma N. et al. Clinical and molecular implications of NAB2-STAT6 fusion variants in solitary fibrous tumour. Pathology 2021; 53: 713-719
• 21 Louis DN, Perry A, Wesseling P. et al. The 2021 WHO Classification of tumors of the central nervous system: a summary. Neuro Oncol 2021; 23: 1231-1251
• 22 Schöffski P, Timmermans I, Hompes D. et al. Clinical presentation, natural history and therapeutic approach in patients with solitary fibrous tumor: a retrospective analysis. Sarcoma 2020; 2020: 1385978
• 23 Sekulic A, Migden MR, Oro AE. et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med 2012; 366: 2171-2179
• 24 Kakkassery V, Emmert S, Adamietz IA. et al. Alternative Behandlungsoptionen beim Basalzellkarzinom am Auge. Ophthalmologe 2020; 117: 113-123
• 25 Shields JA, Shields CL, Brotmann HK. et al. Perez N, Eagtle RC. Cancer metastatic to the orbit: the 2000 Robert M Curts Lecture. Ophthalm Plast Reconstr Surg 2001; 17: 346-354
• 26 Raap M, Antonopoulos W, Dämmrich M. et al. High frequency of lobular breast cancer in distant metastases to the orbit. Cancer Med 2015; 4: 104-111
• 27 Riva G, Augugliaro M, Piperno G. et al. CyberKnife radiotherapy for orbital metastases: A single-center experience on 24 lesions. Eur J Ophthalmol 2019; 29: 61-68
• 28 Accetta L, Spielmann H, Bertelmann E. Orbitale Metastase als Erstmanifestation eines neuroendokrinen Tumors. Klin Monbl Augenheilkd 2023;