[Surgical treatment of intraorbital tumors in a tertiary center].

Introduction: Orbital tumors are rarely occurring in significant quantities apart from a few tertially referral centers, so statistically our data represent national proportions and characteristics of the affected patient group. Objective: Review of the tumor surgeries performed during the first three and a half years of the Semmelweis University Orbital Surgery Team (from February 2019 to August 2022). Analysis of the 94 operative cases, mainly based on age distribution, tumor dignity, location, and the type of surgery performed. Method: This is a retrospective study, made by the review of the entire outpatient and surgical patient records of three and a half years in our IT system. We collected and classified the patients’ data according to various aspects, then compared our results to international publications. Only patients with histologically confirmed cancer, operated by colleagues of our workgroup between February 2019 and September 2022, were included in our analysis. Excision of skin lesions affecting only the dermis and subcutaneous tissues, removal of circumscribed conjunctival cysts, and enucleations were excluded from the examined patient group. This is how we dealt with the significant number of orbital surgeries in which the presence of tumor cell proliferation was not confirmed after biopsy. Results: During the three and a half year period, 94 operations were performed due to intraorbital tumor involvement. The surgeries were preceded by physical examination and imaging. We performed biopsy in 38.3% (n = 36), tumor mass reduction in 18.1% (n = 17), complete removal in 43.6% (n = 41) of the cases. Based on the histological findings, 53.2% (n = 50) of the tumors were benign and 46.8% (n = 44) were malignant. The average age was 60.5 years in the malignant, and 39.5 years in the benign group. The most common benign tumor was cavernous hemangioma in 13.8% (n = 13), and the most common malignant tumor was lymphoma in 31.9% (n = 30). Discussion: Benign tumors can mostly be removed in toto, without residual symptoms. In the case of malignant tumors of the orbit, often only the reduction of the tumor mass can be achieved. In significant amount of cases, we plan to take a biopsy based on their morphological characteristics and the anamnesis. This is how we proceed in the case of lymphoma, the therapy of which is conservative. Conclusion: Various tumors can affect the orbit. In our publication, we process the data of 94 patients with intraorbital tumor surgery. 53.2% of the tumors were benign and 46.8% were malignant. The rate of malignant tumors increased with age, and lymphoma is by far the most common of them. 70% of the benign tumors were either vascular, lymphatic or peripheral nerve tumors or dermoid cysts. Benign tumors proved to be completely resectable in 76% of the cases. Orv Hetil. 2023; 164(49): 1947–1953.