Imaging features of orbital neoplasm developed in pediatrics

Transcription

1 Imaging features of orbital neoplasm developed in pediatrics Poster No.: C-1119 Congress: ECR 2015 Type: Educational Exhibit Authors: J. H. Yoo; Seoul/KR Keywords: Eyes, Head and neck, Paediatric, CT, MR, Education, Neoplasia DOI: /ecr2015/C-1119 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. Page 1 of 42

2 Learning objectives A wide spectrum of benign and malignant neoplasms can arise in the pediatric orbit. Imaging plays an important role in the diagnosis and management by depicting the lesion and its extent. The purpose of this study is to illustrate the imaging features of various orbital neoplasms encountered in pediatrics Page 2 of 42

3 Background We retrospectively reviewed our imaging record and collected representative cases of pediatric orbital neoplasm. We categorized orbital diseases based on their tissue of origin into tumors of mesenchymal origin, neural origin tumors, and vascular malformations or tumors, and we added congenital orbital masses. We try to illustrate the best imaging features of the various diseases with the review of teaching points. Page 3 of 42

4 Findings and procedure details The mesenchymal origin tumors were included rhabdomyosarcoma, Langerhans cell histiocytosis, leukemia and lymphoma. Rhabdomyosarcoma is usually developed in ths extraaxial space with bone remodelling or widening space rather than bone destruction, which is different from the Langerhans cell hiotiocytosis accompanying bone destruction. Leukemia and lymphoma can be developed in the lymphoid rich tissue as like conjunctiva, lacrimal gland and eyelid, with bone remodelling or bone destruction extending to intracranium. Neural origin tumors of orbit were included retinoblastoma, optic nerve glioma, meningioma, schwannoma, neurofibroma and neuroblastoma. Retinoblastoma is most common in calcification containing tumor in neonateoptic nerve sheath meningioma is typical with tram-tack like enhancing meninges surrounding /or compressing optic nerve. Optic nerve glioma can be arised from any portion through the optic nerve course, with/ without neurofibromatosis type I. Neuroblastoma is most common metastatic lesion with bone destruction and periosteal malignant bone formation which can be differential from the LCH without periosteal bone reaction. Vascular masses were included capillary hemangioma, orbital lymphangioma, orbital varix, cavernous hemangioma, arteriovenous malformation, carotid cavernous fistula, vascular mass related with syndrome such as PHACE syndrome, choroid angioma in the Sturge-Weber syndrome. True hemangioma is caillary hemangioma with regression in young age. Other vascular masses having variable findings according to vasclar rapid or slow flow and lymhatic channels. Congenital orbital masses were dermoid and epidermoid, lipoma, coloboma, persistent primary hyperplastic vitrous (PHPV), coats disease, congenital cyst, cephalocele. the most common site of dermoid and epidermoid is superoalteral aspect of orbit near the suture or intraosseous lesion with bone erosion. Page 4 of 42

5 Images for this section: Fig. 1 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 5 of 42

6 Fig. 2 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 6 of 42

7 Fig. 3 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 7 of 42

8 Fig. 4 Page 8 of 42

9 Fig. 5 Page 9 of 42

10 Fig. 6 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 10 of 42

11 Fig. 7 Page 11 of 42

12 Fig. 8 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 12 of 42

13 Fig. 9 Page 13 of 42

14 Fig. 10 Page 14 of 42

15 Fig. 11 Page 15 of 42

16 Fig. 12 Page 16 of 42

17 Fig. 13 Page 17 of 42

18 Fig. 14 Page 18 of 42

19 Fig. 15 Page 19 of 42

20 Fig. 16 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 20 of 42

21 Fig. 17 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 21 of 42

22 Fig. 18 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 22 of 42

23 Fig. 19 Page 23 of 42

24 Fig. 20 Page 24 of 42

25 Fig. 21 Page 25 of 42

26 Fig. 22 Page 26 of 42

27 Fig. 23 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 27 of 42

28 Fig. 24 Page 28 of 42

29 Fig. 25 Page 29 of 42

30 Fig. 26 Page 30 of 42

31 Fig. 27 Page 31 of 42

32 Fig. 28 Page 32 of 42

33 Fig. 29 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 33 of 42

34 Fig. 30 Page 34 of 42

35 Fig. 31 Page 35 of 42

36 Fig. 32 Page 36 of 42

37 Fig. 33 Page 37 of 42

38 Fig. 34 Page 38 of 42

39 Fig. 35 Radiology, School of Medicine, Ewha Womans University, Mokdong Hospital - Seoul/ KR Page 39 of 42

40 Conclusion Conclusion: Imaging plays an important role in the diagnosis and management of wide range of pediatric orbital diseases Page 40 of 42

41 Personal information Jeong Hyun Yoo, M.D., Radiology, Mokdong hospital, Ewha Womans Univ. School of Medicine, Seoul, Korea Jill Hunter, M,D., Radiology, Texas childrens hospital, Baylor College, Houston, Tx, USA Page 41 of 42

42 References 1. Imaging spectrum of pediatric orbital pathology: A pictorial review Harsh Kandpal, MD; Sushma Vashisht, MD; Raju Sharma, MD; Ashu Seith, MD, Indian J Ophthalmol 2006;54: The Radiological Spectrum of Orbital Pathologies that Involve the Lacrimal Gland and the Lacrimal Fossa, Won Sang Jung, MD1, Kook Jin Ahn, MD1, Mi Ra Park, MD2, Ji Young Kim, MD1, Jae Jeong Choi, MD1, Bum Soo Kim, MD1, Seong Tai Hahn, MD1Korean J Radiol 2007;8: Page 42 of 42