Clinical and Treatment Features of Orbital Neurogenic Tumors

• Main Authors: Pınar Bingöl Kızıltunç, Kaan Gündüz, Esra Erden
• Format: Article
• Language: English
• Published: Galenos Yayinevi 2013-10-01
• Series: Türk Oftalmoloji Dergisi
• Subjects: Meningioma; neurofibroma; optic nerve glioma; orbit; schwannoma
• Online Access: http://www.oftalmoloji.org/article_2296/Clinical-And-Treatment-Features-Of-Orbital-Neurogenic-Tumors

Purpose: To evaluate the clinical and treatment features of orbital neurogenic tumors. Material and Method: The records of 35 patients with orbital neurogenic tumors who were diagnosed and treated at Ankara University Faculty of Medicine, Department of Ophthalmology, between 1998 and 2011 were evaluated retrospectively. Results: Orbitotomy via a cutaneous approach was performed in 21 (60%) cases and orbitotomy via a transconjunctival approach was performed in 7 (20%) cases. Three (8%) cases had been operated at different centers. Four (12%) cases were diagnosed clinically. Total excisional biopsy was performed in 11 (31.4%) cases, subtotal excisional biopsy was performed in 7 (20%), and incisional biopsy was performed in 10 (28.6%) cases. 14 (40%) 35 cases were diagnosed as meningioma, 12 (34%) as peripheral nerve sheath tumor, and 9 (26%) cases were diagnosed as optic nerve glioma. Six (43%) meningioma cases were optic nerve sheath meningioma, 5 (36%) were sphenoid wing meningioma, 2 (14%) were ectopic meningioma, and 1 (7%) was perisellar meningioma. Six (50%) of peripheral nerve sheath tumors were schwannoma, 2 (16%) were solitary neurofibroma, 4 (34%) were plexiform neurofibroma. External beam radiotherapy was performed in 15 (42.8%) cases, cyberknife radiosurgery in 1 (2.8%) , chemotherapy in 1 (2.8%), and enucleation ( because of neovascular glaucoma and vitreous hemorrhage) was performed in 1 (2.8%) case. Discussion: The most common orbital neurogenic tumors are meningioma, peripheral nerve sheath tumor, and optic nerve glioma. For meningioma and glioma, external beam radiotherapy is required; for schwannoma and solitary neurofibroma, total excisional biopsy is the preferred treatment. The success of visual and anatomic results are high after treatment. (Turk J Ophthalmol 2013; 43: 335-9)