Orbital tumors can cause eye bulging, pain, reduction in eye movements and double vision. Orbital tumors that compress the optic nerve can lead to gradual vision loss.

Orbital tumors in Adults:

The most common orbital tumor in adults is the cavernous haemangioma, that usually represents an incidental finding on brain imaging. It can rarely cause bulging of the eye. Other benign tumors are sphenoid wing meningiomas, lymphangiomas, optic nerve gliomas and pleomorphic adenomas of the lacrimal gland.

Malignant tumors include lymphomas, metastatic cancer, lacrimal gland adenocarcinoma and squamous cell carcinoma. Diagnosis is confirmed with imaging (CT or MRI) and biopsy of the lesion. All patients diagnosed with a malignant orbital tumor need to be worked up systemically by an oncologist to detect any possible metastases and plan treatment. The treatment of the orbital tumor includes surgical excision and radiotherapy.

Orbital tumors in children:

Benign orbital tumors in children include dermoid cysts, capillary haemangiomas and lymphangiomas. Dermoid cysts need complete excision to prevent risk of traumatic rupture and secondary orbital inflammation. Capillary haemangiomas usually respond well to systemic treatment with beta-blockers. Finally lymphangiomas are usually treated conservatively but if indicated they can be surgically debulked or treated with intralesional sclerotherapy.

Malignant tumors are rare and include rabdomyosarcomas and metastatic tumors related to leukaemia or neuroblastomas.