Poloschek C M, Lagrèze W A, Ridder G J, Hader C
Universitäts-Augenklinik Freiburg, Killianstrasse 5, Freiburg, Germany.
Ophthalmologe. 2011 Jun;108(6):510-8. doi: 10.1007/s00347-010-2190-z.
Exophthalmus is the leading sign of space-occupying lesions of the orbit. Patients may further present with lid swelling, impaired ocular motility and optic neuropathy including a relative afferent pupillary defect, compressive optic disc edema or optic atrophy. Orbital tumors can be classified into various categories depending on the etiology, as lymphoproliferative lesions (in particular non-Hodgkin's lymphoma as the most common malignant orbital tumor of adulthood), optic nerve and meningeal lesions, lacrimal gland lesions, secondary orbital tumors which extend to the orbit from neighboring structures and metastases. Slightly less common are vasculogenic and cystic lesions including cavernous hemangioma as the most common benign orbital tumor of adulthood and dermoid cysts as the most common benign orbital tumor of childhood. Rhabdomyosarcoma is the most common malignant orbital tumor of childhood but has a low total incidence. Orbital tumors might not only cause symptoms like pain, diplopia and loss of visual acuity but may also lead to esthetically disfiguring changes. Particular attention should be paid to underlying systemic diseases and generalized tumor diseases. This article illustrates the approach to a detailed clinical and neuroradiological assessment which is mandatory for the care of orbital tumor patients.
眼球突出是眼眶占位性病变的主要体征。患者可能还会出现眼睑肿胀、眼球运动障碍和视神经病变，包括相对传入性瞳孔障碍、压迫性视盘水肿或视神经萎缩。眼眶肿瘤可根据病因分为不同类别，如淋巴增殖性病变（特别是非霍奇金淋巴瘤，是成人最常见的恶性眼眶肿瘤）、视神经和脑膜病变、泪腺病变、从邻近结构延伸至眼眶的继发性眼眶肿瘤以及转移瘤。血管源性和囊性病变略少见，包括海绵状血管瘤（是成人最常见的良性眼眶肿瘤）和皮样囊肿（是儿童最常见的良性眼眶肿瘤）。横纹肌肉瘤是儿童最常见的恶性眼眶肿瘤，但总体发病率较低。眼眶肿瘤不仅可能引起疼痛、复视和视力丧失等症状，还可能导致美观上的毁容性改变。应特别关注潜在的全身性疾病和全身性肿瘤疾病。本文阐述了详细的临床和神经放射学评估方法，这对于眼眶肿瘤患者的护理至关重要。
