Uchimura Masahiro, Hayashi Kentaro, Sakamoto Tatsunori, Nagai Hidemasa
Department of Neurosurgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan.
Advanced Stroke Center, Shimane University Hospital, Izumo, Shimane, Japan.
Surg Neurol Int. 2023 Jul 21;14:259. doi: 10.25259/SNI_404_2023. eCollection 2023.
While most orbital tumors are primary, some are secondary, including extension or invasion from adjacent sites. The diagnosis varies widely, and the treatment strategy depends on the pathological diagnosis. Transcranial and transorbital surgical approaches are typically used. Recently, a transnasal endoscopic approach has emerged as a viable option. We report a case of an intraorbital tumor treated with endoscopic transnasal biopsy and compare the results with those of other surgical approaches.
A 74-year-old woman visited a nearby hospital due to a right eye protrusion and decreased visual acuity. An intraorbital tumor was detected and the patient was referred to our hospital. Head computed tomography revealed a mass along the posterior wall of the right orbital apex. Contrast-enhanced magnetic resonance imaging showed a 37-mm lesion with a uniform contrast effect and no intracranial extension. Intraorbital lymphoma was considered a differential diagnosis, and a biopsy was performed using an endoscopic transnasal approach. The pathological diagnosis was B-cell lymphoma, and chemotherapy was administered.
The endoscopic transnasal approach for intraorbital tumors is less invasive, highly cosmetic, and useful, especially for medial and inferior orbital lesions.
虽然大多数眼眶肿瘤是原发性的，但有些是继发性的，包括来自相邻部位的扩展或侵犯。诊断差异很大，治疗策略取决于病理诊断。通常采用经颅和经眶手术入路。最近，经鼻内镜入路已成为一种可行的选择。我们报告一例经鼻内镜活检治疗眼眶内肿瘤的病例，并将结果与其他手术入路的结果进行比较。
一名74岁女性因右眼突出和视力下降就诊于附近医院。检测到眼眶内肿瘤，患者被转诊至我院。头部计算机断层扫描显示右眶尖后壁有一肿块。增强磁共振成像显示一个37毫米的病变，具有均匀的对比效果，无颅内扩展。眼眶内淋巴瘤被列为鉴别诊断，采用经鼻内镜入路进行活检。病理诊断为B细胞淋巴瘤，并给予化疗。
经鼻内镜入路治疗眼眶内肿瘤具有创伤小、美容效果好且有用的特点，尤其适用于眼眶内侧和下部病变。
