Orbital cavernous haemangioma; profile and outcome of 76 patients managed surgically
Pedro Clarós ORCID Icon, Emmanuel Choffor-Nchinda ORCID Icon, Marta Lopez-Fortuny, Andres Claros ORCID Icon & Salvador Quintana
Received 10 Mar 2019, Accepted 21 Apr 2019, Published online: 01 Jun 2019
Download citation https://doi.org/10.1080/00016489.2019.1618913
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Abstract
Background: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered ‘anatomically’ malignant.
Aims: To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome.
Methods: We realised a hospital-based retrospective case review including data from 76 patient files.
Results: The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) (p < .001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient r = −0.5, p < .001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA.
Conclusion: Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.
Chinese abstract
背景：眼眶海绵状血管瘤（OCH）是成人最常见的原发性眼眶肿瘤之一。它们可以侵犯眶内或邻近结构, 被认为是“解剖学上”恶性的。
目的：报告一系列手术治疗的患者, 他们具有可能的特异性。提出治疗结果的预测因子。
方法：我们进行了一项基于医院的回顾性病例研究, 涉及76名患者的档案资料。
结果：平均年龄为37.8岁。所有患者均观察到单侧突眼。 32名患者（42.1％）发现视力丧失。眼科检查的结果包括眼球突出症（76.3％）、上睑下垂（21.1％）、角膜暴露并发症（19.6％）、斜视（13.2％）和眼底异常（60.5％）。眼底镜检查异常与视力下降（VA）显著相关（p <.001）。小肿瘤占多数（65.8％）, 其大小与VA相关（相关系数r = -0.5, p <.001）。手术主要采用侧眶切开术（94.7％）, 早期术后并发症18例（23.7％）。多变量分析显示肿瘤大小、术前VA和异常眼底镜检查与术后VA显著相关。
结论：临床特征和放射学特征是一致的。肿瘤大小、术前VA和眼底镜检查异常似乎是影响预后的重要因素。外科手术治疗仍主要采用开放式方法。严重并发症少见。
Keywords: Orbital cavernous haemangioma, orbital cavernous vascular malformation, orbitotomy, treatment outcome
Pedro Clarós ORCID Icon, Emmanuel Choffor-Nchinda ORCID Icon, Marta Lopez-Fortuny, Andres Claros ORCID Icon & Salvador Quintana
Received 10 Mar 2019, Accepted 21 Apr 2019, Published online: 01 Jun 2019
Download citation https://doi.org/10.1080/00016489.2019.1618913
Select Language▼
Translator disclaimer
Abstract
Background: Orbital cavernous haemangioma (OCH) is one of the most common primary orbital tumours in adults. They can encroach on intraorbital or adjacent structures and be considered ‘anatomically’ malignant.
Aims: To report a series of patients that were all managed surgically, with possible specificities and propose predictors of treatment outcome.
Methods: We realised a hospital-based retrospective case review including data from 76 patient files.
Results: The mean age was 37.8 years. Unilateral proptosis was observed in all patients. Visual loss was found in 32 patients (42.1%). Findings on eye examination included lagophthalmos (76.3%), blepharoptosis (21.1%), complications of corneal exposure (19.6%), strabismus (13.2%) and fundoscopic abnormalities (60.5%). Abnormal fundoscopy was significantly associated with decreased visual acuity (VA) (p < .001). Small tumours were predominant (65.8%) and size was associated with VA (correlation coefficient r = −0.5, p < .001). Surgery was mainly by lateral orbitotomy (94.7%), with early post-operative complications in 18 patients (23.7%). Multivariable analysis showed that tumour size, preoperative VA and abnormal fundoscopy were significantly associated with postoperative VA.
Conclusion: Clinical and radiological profiles are consistent. Tumour size, preoperative VA, and abnormal fundoscopy seem to be important factors that could influence outcome expectations. Surgical management is still predominantly by open approaches. Severe complications remain rare.
Chinese abstract
背景：眼眶海绵状血管瘤（OCH）是成人最常见的原发性眼眶肿瘤之一。它们可以侵犯眶内或邻近结构, 被认为是“解剖学上”恶性的。
目的：报告一系列手术治疗的患者, 他们具有可能的特异性。提出治疗结果的预测因子。
方法：我们进行了一项基于医院的回顾性病例研究, 涉及76名患者的档案资料。
结果：平均年龄为37.8岁。所有患者均观察到单侧突眼。 32名患者（42.1％）发现视力丧失。眼科检查的结果包括眼球突出症（76.3％）、上睑下垂（21.1％）、角膜暴露并发症（19.6％）、斜视（13.2％）和眼底异常（60.5％）。眼底镜检查异常与视力下降（VA）显著相关（p <.001）。小肿瘤占多数（65.8％）, 其大小与VA相关（相关系数r = -0.5, p <.001）。手术主要采用侧眶切开术（94.7％）, 早期术后并发症18例（23.7％）。多变量分析显示肿瘤大小、术前VA和异常眼底镜检查与术后VA显著相关。
结论：临床特征和放射学特征是一致的。肿瘤大小、术前VA和眼底镜检查异常似乎是影响预后的重要因素。外科手术治疗仍主要采用开放式方法。严重并发症少见。
Keywords: Orbital cavernous haemangioma, orbital cavernous vascular malformation, orbitotomy, treatment outcome
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