EYE TUMOR

EYE TUMOR

Z A L D I , MD

9/24/2012

TUMORS OF THE EYE

ZALDI
FAKULTAS KEDOKTERAN
UNIVERSITAS MUHAMMADIYAH SUMATERA UTARA
MEDAN
2012

Dengan menyebut nama Allah

Yang Maha Pengasih Maha Penyayang.

EYE TUMO9R

ZALDI

9/24/2012

I. TUJUAN INSTRUKSIONAL UMUM

4

Setelah Proses Belajar Mengajar mahasiswa

mampu menegakkan diagnosa jenis-jenis tumor
pada mata yang sering dijumpai dengan melakukan
pemeriksaan sederhana yang akan dipelajari
selama masa perkuliahan secara baik dan benar .

EYE TUMOR

Z A L D I , MD

9/24/2012

II. TUJUAN INSTRUKSIONAL KHUSUS

5

Setelah Proses Belajar Mengajar mahasiswa

mampu mengetahui gambaran klinis , bentuk tumor
sehingga dapat membuat diagnosa banding dari
berbagai jenis tumor baik tumor jinak atau tumor
ganas secara garis besar secara baik dan benar
sesuai dengan kompetensinya

EYE TUMOR

Z A L D I , MD

9/24/2012

Introduction
6

Eye Tumors can :

* Be live threatening

* Reduce vision
* Cause cosmetic problems

EYE TUMOR

Z A L D I , MD

9/24/2012

Eye Tumor Classification

7

External : on palpebra, conjunctiva, cornea and

lacrimal sac.

Intraocular

Orbital

EYE TUMOR

Z A L D I , MD

9/24/2012

Benign External Eye Tumor

8

Dermoid cyst and dermoid tumor

Xanthelasma
Millium
Papilloma
Nevus
Verruca vulgaris = Common wart
Molluscum contagiosum

EYE TUMOR

Z A L D I , MD

9/24/2012

Malignant External Tumor

9

Carsinoma in situ
Basal cell carcinoma
Squamous cell carcinoma
Aquired melanosis
Lacrimal sac tumor

EYE TUMOR

Z A L D I , MD

9/24/2012

Intraocular Eye Tumor

10

1. Malignant melanoma.

2. Retinoblastoma.

3. Uveal metastatic tumor.

EYE TUMOR

Z A L D I , MD

9/24/2012

Orbital Tumor (1)

11

Hemangioma
Neurogenic Tumor :
* Optical nerve glioma
* Meningioma
* Neurofibroma
Rhabdomysarcoma

EYE TUMOR

Z A L D I , MD

9/24/2012

Orbital Tumor (2)

12

Lacrimal gland tumor :

* Benign mixed tumor
* Adenoid cystic carcinoma
Metastatic tumor
Malignant lymphoma
Idiopathic orbital inflammatory desease
Dysthyroid ophthalmopathy

EYE TUMOR

Z A L D I , MD

9/24/2012

Dermoid Cysts
13

Congenital tumor
The tumor wall consists of dermis and epidermis
layer
Location : supero-temporal
Tumor palpation : firm, round, and smooth, freely
mobile under the skin.
T/ : In toto excision

EYE TUMOR

Z A L D I , MD

9/24/2012

Dermoid Cysts
14

EYE TUMOR

Z A L D I , MD

9/24/2012

Dermoid Tumor
15

Congenital, located at the limbus

Consists of connective tissue with hair follicles &
sebaceus gland, walled by stra- tified squamous
epithelium
Signs : solid, smooth, round, protruded mass, whitish
in colour
T/ : excision

EYE TUMOR

Z A L D I , MD

9/24/2012

Dermoid Tumor
16

EYE TUMOR

Z A L D I , MD

9/24/2012

Nevus = Benign Melanoma

17

EYE TUMOR

Z A L D I , MD

9/24/2012

Papilloma
18

Location : margo palpebra and limbus

Signs : tumor mass is cauliflower-like and
pedunculated
Large tumor size can resembles malignancy
Has regrowth tendency
Related to viral infection.
T/ : In toto excision.

EYE TUMOR

Z A L D I , MD

9/24/2012

Verruca vulgaris
19

Not a true tumor

Etiology : viral
Shape : various

T/ : excision

EYE TUMOR

Z A L D I , MD

9/24/2012

Molluscum Contagiosum
20

Etiology : a pox viral

Signs :
small, pale, waxy,
umbilicated nodule
T/ : excision

EYE TUMOR

Z A L D I , MD

9/24/2012

Basal Cell Carsinoma

21

Known as Basal cell epithelioma

90% on eyelids
Age 50-55 y, particularly men
Signs : ulcerative small node, with elevated border
Rarely cause metastasis

EYE TUMOR

Z A L D I , MD

9/24/2012

Basal Cell Carsinoma: Therapy

22

Wide excision with 2 mm safety margin,

controlled by frozen section
Radiotherapy
Cryotherapy
Mohs Chemosurgery
Curetage and electrodessication

EYE TUMOR

Z A L D I , MD

9/24/2012

Basal Cell Carsinoma

23

EYE TUMOR

Z A L D I , MD

9/24/2012

Squamous Cell Carsinoma

24

2 - 9 % of eyelid malignancies
More aggressive tumor than BCC
Slow growth
Metastasis to regional lymph nodes
Sign : plaque-like, nodular, ulcerating tumor
T/ : similar to basal cell carcinoma

EYE TUMOR

Z A L D I , MD

9/24/2012

Intraocular Malignant Melanoma

25

Iris Melanoma : 6-8%

Uveal melanoma : 9%

Choroidal Melanoma : 85%

EYE TUMOR

Z A L D I , MD

9/24/2012

Retinoblastoma
26

The most common primary, malignant, intraocular

tumor of childhood
Occurring in about 1:20.000 live birth
No sexual predilection
The vast majority become clinically apparent
before the age of 3 years

EYE TUMOR

Z A L D I , MD

9/24/2012

LEUCOCORIA

RETINOBLASTOMA

Genetic Aspects of Retinoblastoma

29

Non heritable account for 60% of cases

The tumors arises at the somatic level in a single
retinal cell
Heritable account for 40 % of cases.
The primitive retinal cells are predisposed to
malignant transformation
Only 6% have a positive family history

EYE TUMOR

Z A L D I , MD

9/24/2012

Presentation of Retinoblastoma
30

Leukocoria (white
pupillary reflex), in
about 60% cases.
Strabismus, in 20% of
cases
Secondary glaucoma
Anterior segment
invasion

EYE TUMOR

Orbital inflamation
Proptosis
Metastasis (regn. LN)
Routine exam to risk
patients

Z A L D I , MD

9/24/2012

Signs of Retinoblastoma
31

Early intraretinal tumor : a flat or round white

lesion
Endophytic tumor : white mass, secondary
calcification
Exophytic tumor :
* Multiglobulated white mass with
retinal detachment
*
Vitreus hemorrhage

EYE TUMOR

Z A L D I , MD

9/24/2012

Retinoblastoma
Special Investigations
32

Ultrasonography

CT-Scan : to detect calsification

MRI : to detect optic nerve infiltration

EYE TUMOR

Z A L D I , MD

9/24/2012

Retinoblastoma Treatment
33

Unilateral cases : enucleation, including about 10

mm of optic nerve
Bilateral cases : enucleation of the worse eye,
irradiation of the fellow eye
Extraocular growth : excenteration
Metastasis : palliative radiotherapy or
chemotherapy

EYE TUMOR

Z A L D I , MD

9/24/2012

ENUCLEATION
34

EYE TUMOR

Z A L D I , MD

9/24/2012

Retinoblastoma Treatment
35

EYE TUMOR

Z A L D I , MD

9/24/2012

Capillary Hemangioma
36

Appear at the first month after birth

Strawberry birthmark on palpebral skin
1st year enlargement followed by regression
T/ : * Steroid, low dosage of irradiation
*
Dysfunction or marked deformity is
an
indication of excision

EYE TUMOR

Z A L D I , MD

9/24/2012

Superficial capillary hemangioma of

lid.

Capillary Hemangioma
38

EYE TUMOR

Z A L D I , MD

9/24/2012

Rhabdomyosarcoma
39

The most common primary orbital malignant tumor in

children.
Presentation : rapidly progressive proptosis on
children 7 year of age
Sign : A palpable mass at nasal superior orbit
Swelling and injection of overlying skin but the skin is
not hot
D/ : USG and CT, biopsy
T/ : Irradiation and chemotherapy
EYE TUMOR

Z A L D I , MD

9/24/2012

Rhabdomyosarcoma
40

EYE TUMOR

Z A L D I , MD

9/24/2012

REFERENCES
42

American Academy of Ophthalmology, Eye Tumor ,

2009-2010.
Khurana A, Ophthalmology, New Delhi, New Age
Internasional (p) Limited Publisher, 1998.
Vaughan D.G, Asbury T, Riordan P, Oftalmologi
Umum, Widya Medika, Jakarta, 2000.

EYE TUMOR

ZALD I

9/24/2012

Segala puji bagi Allah, Tuhan semesta alam.

43

EYE TUMOR

ZALD I

9/24/2012