Tumors may occur in any part of the orbit. Their management demands either total excision or biopsy samples obtained through orbitotomy. The key to appropriate surgical management is a thorough knowledge of the anatomy and correct approach to reach the different spaces. The safest yet the most direct approach to access the tumors should be used. A multidisciplinary team may be required for deeply located lesions, close to the orbital apex, requiring advanced procedures. Here we give a brief review of the evolution of the various orbitotomy procedures and the surgical approach to the same.
A 60-year-old male sought medical advice for painless progressive swelling in the left eye associated with protrusion of the eyeball and diminution of vision for the past 6 months. A computed tomography scan was done which revealed a heterogeneous lesion in the inferotemporal orbit lying close to the globe without any bony erosions or intracranial extension. Incisional biopsy revealed spindle or stellate cells in a myxoid matrix with abundant thin-walled vessels. On Immunohistochemistry, the tumour was positive for vimentin and SMA. It was negative for Desmin and S-100. A diagnosis of superficial angiomyxoma of the eyelid with orbital extension was thus made. Surgical excision under general anaesthesia was planned and the mass removed in toto. The histopathological examination of the same revealed findings similar to the incision biopsy. The patient is being followed up with no recurrences till date.
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