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TUMORS OF THE EYE

Teguh Anamani

TUMORS OF THE EYE

TUMORS OF THE EYELIDS


CONJUNCTIVAL TUMORS
INTRAOCULAR TUMORS
ORBITAL TUMORS

TUMORS OF THE EYELIDS


BENIGN LID TUMORS

NEVUS
PAPILLOMAS
MOLLUSCUM CONTAGIOSUM
XANTHELASMA
KERATOACHANTOMA
CYSTS
HEMANGIOMA

NEVUS
Congenital
Rarely become
malignant
Tx: surg excision
(cosmetic)

PAPILLOMAS
most common
2 TYPE :
Squamous cell
papilloma
(papiloma
skuamosa)
Seborheic
keratoses
(papiloma sel
basal, veruka

MOLLUSCUM
CONTAGIOSUM
Poxvirus
TYPICAL LESION :
a small, flat,
symmetric,
centrally
umbilicated. Lid
margin lesion
hidden in the cilia
konjungtivitis,
keratitis
Multiple : HIV

XANTHELASMA
Common, bilaterally
near the inner angle of
the eye
Yellow plaques
Collections of lipid
containing histiocytes
in the dermis of the lid
Hiperlipidemia 2/3 N
serum lipids
Tx: cosmetic surg
excision,
cauterized,laser
surgery

KERATOACANTHOMA
Sun-exposed of adult
Immunodeficiency,xeroderma
pigmentosum, Muir-Torre syndr>
Elevated lesion, central crater
containing keratin,enlarged rapidly
Spontaneous involition
Th/ excisional
biopsycosmetic/possibility
squamous cell ca

CYSTS
Obstruction of pilosebaceous (milia and
pilar cysts) or congenital and traumatic
subepithelial implantation of surface
epithelium (epidermal inclusion cysts)
Dermoid cysts (hair follicles and
sebaceous glands) congenital. Most
near orbital rim superotemporally
Hydrocystoma (sudoriferous cysts, ductal
cysts) eccrin/apocrine sweat duct.

HEMANGIOMA
CAPILLARY HEMANGIOMA (strawberry
nevus)
Most common congenital vascular
tumor of the eyelid
composed proliferating capillaries
and endhothelial cells
grow rapidly at or shortly after birth
(90% < 6 months), regress
spontaneously
over 6-7 yr,

CAPILLARY HEMANGIOMA (strawberry nevus)

Superficial : bright red, Deeper :


bluish/violet
Treated block the visual axis or
induces astigmatism
Secondary anisometropia, refractive
amblyopia, strabismus
Tx: no treatment, corticosteroid or
interferon alfa inj, partial surgical
excision

Nevus flammeus (port wine


stain)
Sturge-weber syndr
More purple
Composed of dilated, cavernous
vascular chanel
At birth, no grow or regress
Cosmetic th/ laser surgery

CAVERNOUS HEMANGIOMA
. Composed of large

endothelium-lined
vascular channels with
smooth muscles in their
wall
Developmental , >>
after first decade
. Grow slowly
. Women > Men
. Loc : muscle cone
proptosis, hyperopia
. Regress spontaneously
(-)

PRIMARY MALIGNANT TUMORS


OF THE LIDS
CARCINOMA
. Basal Cell Ca
. Squamous Cell Ca
The most common malignant
ocular tumors
Fair complexioned individuals+sun
exposure
Sebaceous gland ca

BASAL CELL CARCINOMA

Grow slowly
Painless
Nodule or ulcer
Local invasive
Metastase (-)
95% of lid cancer
Tx: surg excision,
radiotherapy or
cryotherapy

SQUAMOUS CELL
CARCINOMA
Grow slowly
Painless
Hyperkeratotic
noduleulcerated
Local invasive
Metastase (+)
Tx: surg excision,
radiotherapy,
chemotherapy

SEBACEOUS GLAND
CARCINOMA

Meibomian and zeis


50% chalazia and cronic blepharitis
Aggressive than squamous cell ca
Extending orbit, invading
lymphatics and metastase

MALIGNANT MELANOMA
Similar to those
elsewhere in the skin
Not all malignant
melanomas are
pigmented
Prognosis depth of
invasion / thickness
Tx: surg excision

CONJUNCTIVAL TUMORS
PRIMARY BENIGN TUMORS OF THE
CONJUNCTIVA

NEVUS
DERMOID TUMOR
DERMOLIPOMA
ANGIOMA

PRIMARY MALIGNANT TUMORS OF


THE BULBAR CONJUNCTIVA
CARCINOMA
CONJUNCTIVAL DYSPLASIA
MALIGNANT MELANOMA

NEVUS

1/3 of cases
lack of pigment
1/2 of cases cystic
epithelial inclusion
Rarely become
malignant
> 3rd decade high
risk to malignant

DERMOID TUMOR
CongenitalA
smooth, rounded,
yellow elevated
mass, hair protruding
Loc : inferotemporal
Tx: surg
excisioncosmetic,
vision

DERMOLIPOMA
A smoothly
rounded
Loc : temporal
quadrant of the
bulbar
conjunctiva
Tx: surg excision

ANGIOMA
Isolated,
circumscribed
capillary
hemangioma
Pyogenic
granuloma :
variety palp
conj over chalazia

CARCINOMA
Loc: >> limbus,
palpebral fissura
A gelatinous surface
Leukoplakic
Slow
Invasion (-)
Metastase (-)
Tx: surg excision,
cryotherapy

CONJUNCTIVAL DYSPLASIA
Benign
Intermediate
between
conj dysplasia
and
malignant ca in
situ
Th/excisional biopsy

MALIGNANT MELANOMA
Rare
Arise from a
preexisting nevus
Tx: excision,
cryotherapy,
exenteration

INTRAOCULAR TUMORS
RETINOBLASTOMA

2/3 of cases appear < 3rd year


30% bilateral inherited
Chromosome band 13q14
Grow endophytic or exophytic, optic nerve
Sign : leucocoria, strabismus,
inflammation
Metastase (+)
Tx: enucleation,
exenteration,radiotherapy, chemotherapy

RETINOBLASTOMA

ORBITAL TUMORS
PRIMARY ORBITAL TUMORS

CAPILLARY HEMANGIOMA
CAVERNOUS HEMANGIOMA
LYMPHANGIOMA
RHABDOMYOSARCOMA
NEUROFIBROMA
OPTIC NERVE GLIOMA
LACRIMAL GLAND TUMORS
LYMPHOMA

METASTATIC TUMORS

RHABDOMYOSARCOMA
Most common
primary malignant
tumor orbit
childhood
Presentation < 10 yr
Rapid growth
Destroy adjacent
bone
and spread into the
brain
Tx: chemotherapy,
radiotherapy,

NEUROFIBROMA
Inherited autosomal dominant
Chr 17
Iris Lisch nodules + cutaneous caf
au lait spot
Optic nerve glioma, meningioma

METASTATIC TUMORS

Hematogenous (+), limphagenous (-)


Men : lung cancer
Women : breast cancer
Childhood : neurobblastoma
Choroid > orbit
Th/ radiation, chemo,excised

SECONDARY TUMORS
NASOPHARYNGEAL CA (> MAXILLARY
SINUS), MENINGIOMA

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