A review of 244 orbital tumors in Japanese patients during a 21-year period: origins and locations.

PURPOSE: To review 244 cases of orbital tumors to determine the distribution of patient age, pathology, and tumor origin and location.
METHODS: We reviewed cases of histopathologically or radiologically verified orbital tumors at our institution from 1981 through 2002, and studied the distribution of patient age, pathology, origin of tumors, and tumor location in the orbit in 244 consecutive patients (aged from 0 to 90 years, mean, 48.7 years; 114 men, 130 women).
RESULTS: Among the 244 cases, 213 (89%) were primary orbital tumors, 23 (9%) were secondary tumors originating in contiguous spaces, and 8 (2%) were metastatic tumors. Regarding the location in the orbit, 122 tumors (50%) were extraconal, 36 (15%) were intraconal, and 86 (35%) were in the lacrimal gland area. The common tumors were reactive lymphoid hyperplasia (22%) and malignant lymphoma (20%) in the extraconal area; cavernous hemangioma (25%), optic nerve glioma (14%), and optic nerve sheath meningioma (14%) in the intraconal area; and malignant lymphoma (40%) and pleomorphic adenoma (24%) in the lacrimal gland area. The age distribution of the 244 patients exhibited two peaks, at 0 to 9 years and 60 to 69 years. In the 0- to 9-year-old patients, the most common tumors were dermoid cyst (26%), optic nerve glioma (11%), capillary hemangioma (11%), and hemorrhagic lymphangioma (11%). On the other hand, in patients over 40 years of age, the common tumors were malignant lymphoma (31%), orbital pseudotumor (24%), pleomorphic adenoma (10%), and cavernous hemangioma (9%).
CONCLUSIONS: The pathologic profiles of orbital tumors were characterized according to patient age and the location of the tumor in the orbit. The age of onset, tumor location, and radiological findings provide us with important information for the diagnosis of a tumor prior to biopsy or tumor resection and for the determination of the treatment strategy.