Secondary squamous cell carcinoma of the orbit

Arch Ophthalmol. 1997 Jan;115(1):75-8. doi: 10.1001/archopht.1997.01100150077013.

Abstract

Objective: To evaluate the origin and biological behavior of secondary orbital squamous cell (SCC) and mucoepidermoid carcinoma.

Methods: A retrospective review of 30 consecutive patients with SCC and mucoepidermoid carcinoma of the orbit seen over a period of 8 years at a large ophthalmic hospital in Saudi Arabia.

Results: A total of 51 secondary orbital tumors were seen in the 8-year period from 1983 through 1991; 30 (60%) of the 51 cases were SCC. There were 16 male and 14 female patients, with an age range of 38 to 80 years and a mean age of 65 years. In 28 (93%) of the 30 patients, the tumor originated in the conjunctiva. Orbital involvement by conjunctival SCC was the most common cause of secondary orbital tumors encountered in patients older than 19 years. Four patients had concomitant paranasal sinus involvement, 4 patients exhibited intraocular invasion, and 2 others were found to have intracranial extension of the SCC. Six (20%) of the 28 patients developed regional lymph node metastases during the course of their illness. All patients were treated by orbital exenteration, with or without radiation therapy. Seven (23%) of the 28 patients died of their disease.

Conclusions: Orbital SCC is an aggressive and life-threatening condition. Most cases result from secondary extension of conjunctival SCC, a common disease in Saudi Arabia. Several factors contribute to the aggressiveness of conjunctival SCC in this geographic location, including continual exposure to UV rays, chronic irritation, and genetic factors. Delay in presentation for treatment, inadequate initial resection of conjunctival lesions, and the aggressive mucoepidermoid carcinoma variant of SCC are also factors contributing to orbital invasion.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / radiotherapy
  • Brain Neoplasms / secondary*
  • Brain Neoplasms / surgery
  • Carcinoma, Mucoepidermoid / radiotherapy
  • Carcinoma, Mucoepidermoid / secondary*
  • Carcinoma, Mucoepidermoid / surgery
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / secondary*
  • Carcinoma, Squamous Cell / surgery
  • Conjunctival Neoplasms / pathology*
  • Conjunctival Neoplasms / radiotherapy
  • Conjunctival Neoplasms / surgery
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Orbit Evisceration
  • Orbital Neoplasms / radiotherapy
  • Orbital Neoplasms / secondary*
  • Orbital Neoplasms / surgery
  • Paranasal Sinus Neoplasms / radiotherapy
  • Paranasal Sinus Neoplasms / secondary*
  • Paranasal Sinus Neoplasms / surgery
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Saudi Arabia