A Study of Tumours Giving Rise to Unilateral Proptosis

Abstract

Study of distribution, clinical features, radiological features, histopathological aspects, management and outcomes of tumours giving rise to unilateral proptosis. This is a prospective study including 40 patients with benign and malignant tumours of orbital, paraorbital and other sites giving rise to unilateral proptosis. Final diagnosis was made following detailed radiological and histopathological examination. Then, treatment modality was decided, which included surgery, radiotherapy, chemotherapy or required combination. Proptosis was measured by simple/plastic ruler exophthalmometry method. The maximum number of cases 8(20%) were in age group 31-40 years. The youngest patient was 4 year old and the oldest was 80 years. M:F ratio was 1.85:1. Malignant tumours were 32(80%) and benign tumours were 8(20%). 12 cases were having 3 mm proptosis (minimum) and one case having 18 mm (maximum). Only 4(10%) orbital tumours were responsible for unilateral proptosis. Paraorbital tumours 34(85%) was the major cause for unilateral proptosis and 2(5%) were from distant sites. Surgery was the mainstay of treatment 14(35%), followed by combined (surgery ? radiotherapy) 5(12.5%), chemotherapy 4(10%), There was 4(10%) mortality, 16(40%) improved 3(7.5%) had same status and 17(42.5%) deteriorated. Thus nasal obstruction is the commonest ENT presenting complains in these patients. The major cause of unilateral proptosis was found to be paraorbital tumours (34%). Thus, a case of proptosis should never be ignored but a thorough ENT and ophthalmic examination is necessary. As malignancy is one of the major cause of unilateral proptosis catching and treating them early will reduce mortality.

Sinonasal Squamous Papilloma with Orbital Infiltration in an Elderly Nigerian Female, Unusual Presentation of an Uncommon Tumor: A Case Report

“…The history of progressive nasal obstruction is common to both benign and malignant nasal growths, but nasal obstruction of long duration as reported in this elderly woman is suggestive of a benign pathology [6]. Typically, the involvement of the orbit in sino-nasal tumorsis seen in paraorbital malignant conditions [5], however, when associated with benign conditions, the common pathologies include inverted papilloma, juvenile angiofibroma, fungal sinusitis and other infectious conditions [8] [9] [10] [11].…”

“…Visual affectation is uncommon in benign orbital conditions [5], however, the long-standing orbital infiltration with severe proptosis, and possibly, compressive optic neuropathy could account for the loss of vision in this elderly woman.…”

“…Sino-nasal tumours which extend into the orbits usually arise from the maxilla-ethmoid complex [5], however, the index case had orbital tumor invasion from the superior-medial wall. Orbital invasion from sino-nasal tumors can occur via various anatomic paths and Saha et al [6] in their study, reported that inverted papillomas invaded the orbit via the sphenoid in 4% of cases, and via erosion of the lamina papyracea in 13% of cases.…”

“…Orbital tumors cause proptosis, the anterior protrusion of the eyeball within the orbit and this can be from primary space occupying lesions of the orbit, secondary extension from the para-orbital structures, or distant mestasis. Keche et al [5] in their review of causes of unilateral proptosis reported that 85% of unilateral proptosis resulted from para-orbital tumors, 10% were primary orbital tumors, and 5% from distant metastasis. Similarly, our patient had unilateral proptosis following orbital tumor invasion from a primary sino-nasal tumor.…”

Sinonasal Mass - A Diverse Clinicopathological Entity – An Experience in a Tertiary Care Centre in the North Eastern India

“…Proptosis as a presenting symptom is found in only 20% benign sinonasal conditions while it is encountered in almost 80% of cases of sinonasal malignancies. 6 In a study of 112 cases by Bist et al, eye involvement was found in only 10% of the total cases of sinonasal mass. 7 In the present study, ocular involvement in the form of proptosis was seen in 3 cases (8.9%) all of which were malignancies.…”