PubMed1981
Unilateral exophthalmos related to orbital diseases was analyzed in 37 cases. Thirty-four out of 37 cases were operated on and histologically verified. The cases included five pseudotumors, five intracranial tumors invading the orbit, four carotid-cavernous fistulas, three mucoceles, two lacrimal gland tumors, two cavernous angiomas, two osteomas, two histiocytomas, two fibrous dysplasias, one neurinoma, one meningioma, one embryonal rhabdomyosarcoma, one metastatic tumor, one venous malformation, one orbital meningoencephalocele, one infraclinoid internal carotid giant aneurysm, three mass lesions not verified operatively. The location of mass lesions in the orbit was diagnostically significant and was certified by CT scan. Mucocele and osteoma occurred at the medial site of the orbit. Lacrimal gland tumors were located anterolaterally in the orbit. Pseudotumors, cavernous angiomas, and the neurionoma were situated posterior to the orbital bulb. As for age distribution, meningoencephalocele, venous angioma, fibrous dysplasia, histiocytoma and embryonal rhabdomyosarcoma occurred in infancy and childhood. The onset and course of the orbital mass lesions were characteristic in the disease process: carotid-cavernous fistula and infraclinoid internal carotid giant aneurysm occurred suddenly. Malignant tumors, such as adenoid cystic carcinoma, embryonal rhabdomyosarcoma and metastatic tumor, revealed rapidly progressive exophthalmos. Benign tumors and mucocele were slowly progressive. Orbital meningoencephaloceles were observed at birth and no remarkable change thereafter. Pseudotumors were progressive at the initial disease process and later became stationary or regressive. Venous malformation showed intermittent exophthalmos. The frontozygomatic operative approach for orbital mass lesions was applied when the tumors were large enough and located laterally in the orbit.