Epidemiology of Orbital Tumors during 11 Years in a Referral Center in Iran

To report the frequency of different orbital tumors from Labafi Nejad Hospital, Iran.

This retrospective consecutive case series includes all records coded with a diagnosis of “orbital tumor” along with a definite histopathologic diagnosis from April 2008 to March 2019. All Patients with definite histopathologic diagnosis (327 cases) were included in the study and the other cases were excluded.

A total of 327 orbital space-occupying lesions (SOLs) with definite histopathologic diagnoses were identified during the 11 years of the study. Affected subjects comprised 183 (56%) female and 144 (44%) male patients with a mean age of 30±21.6 years. Overall, 276 (84.4%) of the SOLs were benign, whereas 51 (15.6%) were malignant; 236 (72.2%) of the lesions were extraconal, while 91 (27.8%) were intraconal; 306 (93.6%) of them were primary, 18 (5.5%) were secondary, and only 3 (0.9%) were metastatic. The most common types of lesions in decreasing frequency were cystic, vascular, inflammatory, and lymphoproliferative, mesenchymal, neurogenic, secondary and metastatic, and epithelial lacrimal gland tumors. Dermoid cysts were the most frequent orbital SOL with 109 cases (33.3%) and also the most common benign lesion. Malignant lymphoma with 12 cases (3.7%) was the most prevalent malignant orbital SOL. Dermoid cysts and malignant lymphoma were the most prevalent benign and malignant orbital SOLs, respectively. The ratio of malignant to benign lesions was 0.46 in children (≤18 years), 0.84 in middle-aged patients (19-59 years), and 5.2 in older (≥60 years) cases. Rhabdomyosarcoma was the most common malignancy in children; lymphoma was the most frequent malignancy in middle-aged subjects and invasive basal cell carcinoma from the eyelids was the most common malignancy in the old age group. The superotemporal quadrant was the most frequent site of involvement and proptosis was the most common presenting symptom.

Benign, extraconal, and primary orbital SOLs were more frequent than malignant, intraconal, and secondary lesions in this report. The ratio of malignant lesions increased with age in our cohort.