The Journal of the Arkansas Medical Society Issue 5 Volume 115 | Page 14

SCIENTIFIC ARTICLE
Epidemiological Analysis of Orbital Masses
at Tertiary Centers in Central Arkansas
Jarod M. Santoro, MD; 1 Heather Bartels, MD; 1 John D. Pemberton 1,2
1
UAMS, College of Medicine, 2 UAMS, Department of Ophthalmology
Keywords: orbital, tumor, mass, histopathology
Abstract
O
rbital tumors and simulating masses may present at
any age and represent a variety of both benign and ma-
lignant lesions. It is important to index the frequency of orbital
lesions in Arkansas to assist clinicians in the region with the formation of differ-
ential diagnosis and expedite appropriate referrals and treatment of patients.
This study looks at the incidence of orbital tumors and simulating masses with
histopathological confirmation seen at tertiary institutes in central Arkansas in
patients of any age over a 15-year period. This study reports the most com-
mon orbital masses in age groups 0-18, 19-39, 40-64, and 65 and over.
Orbital tumors and simulating masses may present at any age and repre-
sent a variety of both benign and malignant lesions. Different types of orbital
lesions can affect the orbit and surrounding structures. These masses can
cause ptosis, proptosis, globe displacement, vision loss, altered ocular motility,
and some can be life-threating. 1,2,3
Several studies have reported on the frequencies of orbital tumors, yet de-
termination of a true incidence is difficult due to variability of methods across
published studies. 1 Additionally, many studies lack complete histopathological
confirmation. 1,2 Reported data of orbital lesions vary between series, depend-
ing on the population studied. Some studies have looked at only certain age
groups or geographical area, while others used diagnoses based off of clinical,
radiographic, and/or histopathologic findings. 1,2,3
Table 1
Category
The goal of this study was to determine the incidence of different types
of histopathologically confirmed orbital tumors and simulating masses seen
at tertiary institutes in central Arkansas in patients of any age over a 15-year
period. It is the authors’ goal that information from this study regarding inci-
dence and phenotype of particular orbital masses will serve as a reference for
physicians in central Arkansas as they counsel patients and provide appropri-
ate work up and referral.
Methods
Upon approval by the UAMS IRB, a retrospective search of histopathologic
diagnoses from orbital masses was conducted at both UAMS and Arkansas
Children’s Hospital. Cases were identified by search of CPT codes for orbital
tumors and simulating masses and confirmed by documented histopathologic
diagnosis. Search was conducted between April 1999 and April 2015 and in-
cluded patients of all ages.
Upon compilation of cases following the above screen, strict inclusion and
exclusion criteria were applied. For inclusion into this study, the lesion had to
be an orbital mass, tumor, or simulating lesion involving the orbit in which its
final diagnosis was made by histopathological biopsy. Lesions were excluded if
Table 2
Number of
Patients Percent
Cystic Lesions 36 25.4%
Inflammatory Lesions 19 13.4%
Lacrimal Gland Lesions 19 13.4%
Lymphoid or Leukemic Lesions 17 12.0%
Vasculogenic Lesions 14 9.9%
Types of Orbital Mass
Number of Patients Percent Females 81 57% Secondary Tumors from Adjacent Structures 10 7.0%
Males 61 43% Lipocytic or Myxoid Lesions 9 6.3%
Number of Patients Percent Miscellaneous 6 4.2%
Caucasian 106 75% Osseous/Fibro-osseous Lesions 3 2.1%
African American 25 18% Metastaric Lesions 3 2.1%
Hispanic 7 5% Carcinoma 2 1.4%
Asian 1 1% Peripheral Nerve Lesions 2 1.4%
Indian 1 1% Fibrocytic Lesions 1 0.7%
Unknown 2 1% Sarcoma 1 0.7%
Category
110 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY
VOLUME 115