Orbital lipoma
Introduction
Introduction to orbital lipoma Orbital lipoma is characterized by a downward displacement of the eyeball due to the tumor being located in the upper and posterior. In some cases, especially spindle cell lipomas tend to occur in front of the eyelids, and a smooth mass can be seen above the eyeball. Orbital lipoma is a representative of fat cells or fatty tumors. Although they are common in various tissues of the body, especially subcutaneous tissues, orbital lipomas are rare. A typical variant of this type of tumor is called spindle cell lipoma, which has been found in the eyelids. basic knowledge The proportion of illness: 0.3% Susceptible people: no special people Mode of infection: non-infectious Complications: eyeballs
Cause
Causes of orbital lipoma
Etiology and pathogenesis
The etiology and pathogenesis are still unclear. The main and physical and chemical factors as well as the individual factors cause fat cell hyperplasia, and the genes also have a certain relationship. Various environmental and genetic carcinogenic factors cause DNA damage in a synergistic or sequential manner. , thereby activating the proto-oncogene and/or inactivating the tumor suppressor gene, plus the alteration of the apoptosis-regulating gene and/or the DNA repair gene, which in turn causes abnormal expression levels to cause transformation of the target cell. The transformed cells are mostly clonal hyperplasia, and after a long multi-stage evolution process, one of the clones is relatively unrestricted, and the additional mutation causes the tumor to occur.
Prevention
Orbital lipoma prevention
Orbital lipoma is a benign tumor. Like other tumors, because the cause is not very clear and lacks effective preventive measures, it is generally considered to avoid contact with toxic and hazardous substances and radioactive sources, avoid the use of drugs with immunosuppressive effects, and avoid chemical substances. Long-term use, reduce the irrational use of chemical fertilizers and pesticides, while paying attention to the rules of eating and drinking, avoiding depression, maintaining a good mentality, paying attention to exercise, enhancing physical fitness, and improving immunity have certain help.
Complication
Orbital lipoma complications Complications
Orbital lipoma is a benign tumor, which grows slowly and is less malignant. It usually causes complications. However, if the tumor is enlarged, it may cause compression of surrounding tissues, resulting in prominent deformation of the eyeball, strabismus, and generally no pain; The tumor is limited and grows slowly, and the optic nerve is rarely oppressed, resulting in loss of vision.
Symptom
Orbital lipoma symptoms Common symptoms Conjunctival foreign body Arroyo eyeball protrusion
In general, patients show painless eyeballs. Because the tumor is located in the upper and posterior, the eyeball shifts downward. It is characterized by some cases, especially the spindle cell lipoma, which tends to occur in front of the eyelid and is smooth and smooth above the eyeball. Lump.
Orbital lipoma mostly occurs in adults, and more unilateral eyelids occur. Because the tumor is less in the muscle cone, the eyeball is non-axial. The eyeball in the upper part of the eye is forward and downward. On the medial side, there is generally no pain sensation. The tumor grows to the anterior aspect of the iliac crest. If the eyelid is turned over, the tumor can be found through the conjunctiva. It is light yellow and the tumor is soft. The conjunctival tumor can slide on the surface of the eyeball.
Examine
Eyelid lipoma examination
Pathological examination: The typical orbital lipoma seen by the naked eye is round or multi-lobed, and the cut surface shows yellow. Its limitation helps to distinguish it from normal fat. Normal fat is irregularly fragmented, spindle-shaped cell lipoma. It is brown or gray.
Under the microscope, typical lipomas are composed of mature fat cells. The fat cells are arranged in a leaf shape, separated by connective tissue partitions. The spindle-shaped cell lipomas have well-differentiated spindle-shaped cells distributed in mature fat cells. These benign manifestations The spindle-shaped cells must be differentiated from the more benign liposarcoma, which appears to have a significant vascular region similar to the primary hemangioma, which contains a hyaluronidase-sensitive Acidic mucopolysaccharides.
1. B-mode ultrasound examination: Clear boundary, strong echo, due to internal blood vessels and fibrous tissue, uneven echo and mild compressibility, CDI shows lack of blood flow signal in the tumor.
2. CT scan of the eyelid: the lesion boundary is clear, the density is the same as or slightly higher than the fat, and the anterior sacral lesion can make the sacral anterior process, and the sputum enlargement can be seen in the longer history.
3. MRI: The location of the tumor is similar to that of CT, but T1WI and T2WI are both medium and high signals. If there are more fibrous tissues in the tumor, the signal may be mottled. The MRI tumor signal characteristics have certain diagnostic value.
Diagnosis
Diagnosis and diagnosis of orbital lipoma
diagnosis
Has a typical clinical manifestations, medical history, especially through the conjunctiva to find a pale yellow tumor, which is helpful for diagnosis.
Differential diagnosis
Several common tumors that need to be identified include schwannomas, meningiomas, benign pleomorphic adenomas of the lacrimal gland, and angioendothelioma.
