Tumors of eye

Orbital tumors Malignant Begin rabdomyosarcoma Dermoid cyst Mucocele Hemangioma Lymphangioma

Benign tumors of the orbit can develop from infancy and grow rapidly or slowly It can be superficial and easily identifiable by external presentation, palpation and x – rays or CT scan Symptoms – proptosis can been seen, visual impairment Examples – dermoid cysts, mucocele, hemangiomas, lymphangiomas, lacrimal tumors and neurofibromas

Mucocele – any dilatation with accumulation of mucus Dermoid cyst – overgrowth of normal, noncancerous tissues comprised of skin, hair and fat Lymphangiomas – malformations of the lymphatic system Hemangiomas Treatment – excision or resection (removal of a portion or all of an organ) and dissection.

Malignant tumors of the orbit Rhabdomyosarcoma (RMS) is the most common It is a type of sarcoma (cancer of connective tissues) Symptoms – sudden painless proptosis of one eye followed by lid swelling, conjunctival chemosis, and impairment of ocular motility Treatment – surgery, radiation therapy and chemotherapy

Eye lid tumors Malignant Basel cell carcinoma Squamus cell carcinoma Malignant melanoma Benign Nevus (plural - nevi) Hemangiomas Milia Xanthelasma Molluscum contagiousum

Benign tumors of the eyelids Nevus – sharp circumscribed and chronic lesions of the skin or mucosa Hemangiomas –tumor of the endothelial cells(which lines the blood vessels) that may be bright, superficial, strawberry red lesions or bluish and purplish deeper lesions Milia – milk spot or oil seed - keratin filled cyst, small, white, slightly elevated cysts of the eyelid Xanthelasma – yellowish, lipid deposits on both lids near the inner angle of the eye Molluscum contagiosum – it’s a viral infection involves mucous membranes caused by poxvirus. The lesions are flesh colored

Treatment – Corticosteroid injection to the hemangioma Astringent (silver nitrate, pottasium permanganate, zinc oxide)chemicals applied to the surface of molluscum lesions Surgical excision Electrocautery – also known as thermal cautery in which direct current is passes through a electrode to the affected area and destruct the unwanted cells.

Malignant tumors of the eyelid Basal cell carcinoma – most common Painless nodule that may ulcerate Lesion may invasive, spreads to the surrounding tissues, grows slowly but does not metastasize Usually appear on the lower lid margin near the inner canthus with pearly white margin

Squamous cell carcinoma – less frequent Resemble basal cell carcinoma Grows slowly and painlessly Ulcerate and invade the surrounding tissues It can metastasize to the regional lymph nodes Malignant melanoma –type of skin cancer which forms from melanocytes (pigment containing cells in the skin)can arise form nevi Spreads to the surrounding tissues and metastasizes to other organs

Treatment Excision of these carcinomas followed by reconstruction with skin grafting

Conjunctiva – tumors Benign Conjunctival nevus Dermolipoma Papillomas Malignant Conjunctival carcinoma Malignant melanoma

Benign tumors of the conjunctiva Dermolipoma- congenital tumor – smooth, rounded growth of fatty tissue in the conjunctiva near the lateral canthus Conjunctival nevus Congenital, benign neoplasm Papillomas – soft irregular projections which appear on the lid margins It is flat, slightly elevated, brown spot that becomes pigmented Treatment – surgical excision

Malignant tumors of the conjunctiva Conjunctival carcinoma – gelatinous and whitish due to keratin formation Treatment – surgical incision and excision Radiation therapy, chemotherapy, cryotherapy – uses cryoprob to freezes and thus destroying the unwanted cells They grow gradually and there will be deep invasion Metastasis is rare Malignant melanoma – rare but arise from pre- existing nevus

Globe – tumors Malignant Retinoblastoma Occular melanoma

Malignant tumors of the globe Retinoblastoma – occurs in childhood and hereditary Initial leukocoria or white pupil with peculiar light reflection and possible strabismus Associated with Uveitis, glaucoma, hyphema (pooling of blood inside the anterior chamber of the eye), nystagmus, and periorbital cellulitis Treatment - enucleation

Ocular melanoma Rare, malignant choroidal tumor Blurred vision, change in eye color Metastatic to liver, lung and breast Treatment – enucleation

Treatment Laser therapy, Radiotherapy Enucleation, Evisceration ,Exenteration Iridectomy - Removal of the affected piece of the iris Choroidectomy - Removal of the choroid layer (the vascular tissue layer between the sclera and the retina) Iridocyclectomy - Removal of the iris plus the ciliary body muscle. Eyewall resection - Cutting into the eye to remove a tumor e.g. melanoma. This operation can be quite difficult to perform. Chemotherapy