orbital fibrosarcoma
Introduction
Introduction to orbital fibrosarcoma Orbital fibrosarcoma is a low-grade malignant tumor, which occurs mostly in the upper and inner fibrous tissues such as periosteum, and grows slowly. The course of the disease is long, the eyeball is progressive and accompanied by the characteristics of pain-based disease. Some cases may recur after surgery, but rarely occur. basic knowledge The proportion of illness: the incidence rate is about 0.002% Susceptible people: more common in women Mode of infection: non-infectious Complications: eye movement disorders
Cause
Causes of orbital fibrosarcoma
Cause:
The etiology of primary orbital fibrosarcoma is not known, and radiation-induced fibrosarcoma confirms the role of radiotherapy in the pathogenesis of cancer.
Prevention
Orbital fibrosarcoma prevention
Mainly pay attention to living habits, it is best to find early treatment. Avoid smoking, smoking has become a well-known carcinogenic factor, associated with 30% of cancer. Tobacco tar contains a variety of carcinogens and cancer-promoting substances, such as 3-4 phenyl propyl hydrazine, polycyclic aromatic hydrocarbons, phenols, nitrosamines, etc. When the tobacco burning smoke is inhaled, the tar particles adhere to the bronchial mucosa. After long-term chronic stimulation, it can induce cancer. Smoking mainly causes cancer in the lungs, pharynx, larynx and esophagus, and it can increase the risk of tumors in many other places. A fair diet may have a preventive effect on most cancers, especially in plant-type foods, which have a variety of anti-cancer ingredients that are effective in preventing all cancers.
Complication
Orbital fibrosarcoma complications Complications, eye movement disorders
Both eye movement disorders and diplopia are related to the location of the tumor.
Symptom
Symptoms of orbital fibrosarcoma Common symptoms Two eyes can not be visually impaired edema eyeballs can not be free to dip eyeballs
Clinically more common in women, can occur in all age groups, children with rapid development of lesions, similar to rhabdomyosarcoma at the time of treatment, manifested as eyeballs, eyelid edema, and some cases can form a huge mass.
Tumors located in the iliac crest can reach the tumor through the gingival margin, and pink tumors can also be found through the conjunctiva. The texture is hard and can be fixed with the bone wall in the advanced stage. Other clinical symptoms vary depending on the location of the tumor, which can show decreased vision and eyeball. Exercise limitation, double vision, orbital fibrosarcoma is less likely to have distant metastases, often local recurrence and requires multiple operations. The primary type of orbital fibrosarcoma is often painless, while radiation-induced and secondary tumors have pain.
Examine
Examination of orbital fibrosarcoma
Pathological examination: Regardless of the clinical changes of the tumor, the pathology of fibrosarcoma is quite typical. It consists of fibroid cells called herringbone, interwoven fascia, immature spindle-forming fibroblasts, and fibroids and fibromatosis. In contrast, tumors have excessive cell proliferation, nucleoli and mitotic activity in the nucleus, and less collagen between cells. Fibrous sarcomas caused by radiation tend to be more malignant than other types, often showing nuclear pleomorphism and tumor giant cells.
Electron microscopy can confirm the fibroblast properties of tumors, and can help distinguish other spindle cell tumors such as rhabdomyosarcoma, schwannomas and fibroblastoma with fibroids. The general specimens are irregular in shape and grayish white. Envelope.
X-ray inspection
The plain film can be free of abnormal performance, or only the density of the temporal region is increased, and a few can be seen as bone destruction of the temporal wall.
2. Ultrasonic exploration
B-ultrasound is characterized by irregular echoes in the irregular shape of the sputum. The boundary is clear, and similar pseudo-envelope echoes may occur. The internal echo is less, often slightly lower than the surrounding tissue, and has no compressibility.
3.CT scan
Fibrosarcoma is a soft tissue mass located outside the muscle cone. The shape is irregular, the boundary is clear, the density of the extraocular muscle is similar, the density is relatively uniform, and there is light or moderate enhancement. It can compress or surround the extraocular muscles, the optic nerve and the like. The structure, which shifts, destroys the iliac bone, invades the sinus, the infraorbital fossa, the intracranial and other adjacent iliac structures.
4.MRI
Fibrosarcoma is a solid soft tissue mass located outside the muscle cone with clear boundaries, low signal on T1WI, high signal on T2WI, uniform signal on most lesions, few with cystic changes, necrosis and hemorrhage, enhanced moderately enhanced, can be wrapped or Invasion of the extraocular muscles or optic nerve can also invade the adjacent structures such as the sinus, and the enhanced scanning combined with fat suppression technology shows more clearly.
Diagnosis
Diagnosis and diagnosis of orbital fibrosarcoma
X-ray film is of little value in the diagnosis of this disease. It is difficult to accurately display the extent of the lesion, and it is difficult to accurately show the relationship between the lesion and the adjacent structure. CT can clearly show the bone wall destruction, which is a reliable indication of malignant lesions. Signs can also clearly show the extent of lesions in the iliac crest, but it is difficult to accurately show the relationship with adjacent structures. MRI can accurately show the extent of lesions and the relationship with adjacent structures. CT should be used as a routine examination method, MRI is indispensable before surgery. Inspection Method.
Imaging differential diagnosis includes:
1 malignant lymphoma: a wider range, often involving the eyelids, lacrimal gland and internal structure, or with other parts of the body lymphoma, often wrapped around the eye, in a "casting" shape, less bone wall bone destruction, density Or the signal is more uniform;
2 rhabdomyosarcoma: occurs mostly in children, the disease progresses rapidly, often accompanied by necrosis or hemorrhage, density or signal is often uneven;
3 metastases: the age of onset is large, and there is a history of primary tumors. The lesions develop rapidly, and more often with bone wall destruction.
