Orbital exenteration: a 10-year experience of a general oncology hospital

The aim of this study is to review the 10-year experience with orbital exenteration, determining the indications, clinical features of patients and the factors that cause the need for exenteration.

The records of patients that underwent exenteration between 1997 and 2007 were reviewed retrospectively. The age, sex, the location of tumour, the duration of symptoms, histopathological diagnosis, and previous recurrences were noted.

Orbital exenteration was performed on 68 patients. Bone resection in 6 and sinusectomy in 13 patients was combined with exenteration. The major indication was secondary orbital tumours accounting for 95.6% of the series and the eyelid and conjunctival tumours were the most frequent. Seven different types of histopathology were encountered: squamous cell carcinoma (31 cases), basal cell carcinoma (26 cases), malignant melanoma (5 cases), sebaceous cell carcinoma (2 cases), rhabdomyosarcoma (2 cases), mucoepidermoid carcinoma (1 case) and adenoid cystic carcinoma (1 case). The rate of previous recurrence was 85.7% in eyelid tumours and 42.1% in the conjunctival tumours.

Large proportion of the patients that underwent exenteration had a history of previous unsuccessful treatment and a long duration of disease. Because exenteration of the orbit is a disfiguring procedure, the incidence must be reduced by early presentation, prompt treatment, and adequate observation to preserve the eye.