Treatment Challenges with Benign Bone Tumors of the Orbit

Abstract

Benign mesenchymal tumors of the craniofacial complex present unique challenges for orbital surgeons because of their potential for orbital compartment syndrome, ocular morbidity, and facial disfigurement and because definitive surgical management may be associated with significant morbidity. While the precise classification of such lesions depends on radiologic as well as histologic evaluations and remains controversial, benign tumors involving the bony walls of the orbit share features of bony expansion, facial deformity, and the potential to cause significant orbital and ophthalmic morbidity. We herein present 2 cases of benign mesenchymal tumors with bony involvement in the orbitofacial region (1 juvenile ossifying fibroma and 1 central giant cell granuloma) and review the current management of similar benign fibro-osseous and reactive bone lesions of the orbit. These rare entities presented share common orbital and ophthalmic manifestations and remain without any effective definitive treatment options.

Multimodal Endoscopic and Trans-Orbital Resection of Recurrent Orbital Fibrous Dysplasia with Orbital Wall Reconstruction

“…Medical treatment with bisphosphonates, however, has demonstrated varying results, with some papers reporting utility and others conferring treatment failure [12,13]. Lastly, denosumab is a monoclonal antibody targeting the RANK ligand that has shown to be promising for slowing tumor progression and pain [14] Further studies are required to determine utility in cases of optic nerve compression [15]. This patient suffered from recurrent craniofacial FD involving the medial and inferior orbital walls with extension into the orbit causing compressive optic neuropathy.…”