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Clinical manifestations of orbital tumors
1. Benign tumors Among eyelid tumors, most are benign tumors, and the common ones are as follows. (1) Eyelid hemangioma? It is a congenital vascular malformation, most of which exists at birth. With the increase of age, the tumor gradually increases, and most of them occur in one eye. Clinically, it can be divided into two types: ① capillary hemangioma, also known as vascular nevus. Long in eyelid skin, both upper and lower eyelids can be involved. At first, it is dark red spots, flat or slightly raised, and later it can grow into lobular or nodular masses, which generally grow slowly and some remain unchanged for life. ② Cavernous hemangioma, which mostly grows under the eyelid skin or bulbar conjunctiva, presents purple-blue grape-like process, is soft and slightly elastic, and can disappear temporarily under pressure. When crying or bowing, the tumor grows rapidly or deepens in color, and sometimes it can feel beating. (2) mole? Also known as pigmented nevus, some people call it benign melanoma. It generally exists at birth, grows rapidly in infancy, then increases gradually, and tends to be stable in adulthood. Most of them grow in the inner and outer canthus of eyelid and eyelid margin; The number and size vary from a grain of rice to the whole eyelid; Brown black or brown gray, slightly higher than the skin, flat surface, hair can grow. Some moles are symmetrically divided into two halves of the upper and lower eyelids, and when they close their eyes, they become one. This kind of nevus is called cleft nevus. (3) xanthoma of eyelid? Common in the elderly, women are more than men, and often have increased blood lipids or cholesterol. It usually occurs on the inner side of the upper eyelid, with symmetrical eyes and different numbers. The tumor is yellowish and flat, slightly higher than the skin, not swollen and painless, and develops slowly. (4) Epidermoid and dermoid cysts? Most of them are caused by congenital dysplasia, but also by trauma or local inflammation. Located in subcutaneous tissue, it is as small as a broad bean and as big as a bird's egg, with smooth surface, soft texture, a little elasticity and general insensitivity. Dermoid cysts generally do not adhere to the skin, but are connected to the periosteum and can grow along the suture line. It is more common in the medial and lateral subcutaneous of orbital margin, and the capsule cavity contains sebaceous gland oil and hair. (5) Papilloma of eyelid? Most of them occur at the edge of eyelid. The tumor is as big as a needle handle, densely arranged, with reddish bulge and itchy feeling. When I grow up, I look like bayberry, which is easy to bleed after scratching, and some patients may become malignant. 2. Malignant Tumors There are four kinds of common eyelid malignant tumors. (1) Malignant melanoma of eyelid? It occurs at the eyelid margin, inner canthus and outer canthus. At first, it looks like a mole, but the pigments are different, and uneven melanin nodules of different sizes can be seen. The local blood vessels are rich and the surface is damaged, which is easy to form ulcers. Generally, patients have only mild itching and no other feelings, which is often ignored. Tumors can invade the entire eyelid, and metastasis can occur in the early stage, such as preauricular lymph node enlargement and liver metastasis. Most of them are over 50. (2) Basal cell carcinoma of eyelid? It accounts for 80% of eyelid malignant tumors, and it usually occurs in the lower eyelid or inner canthus, which is more common in elderly men. In the early stage of tumor, the eyelid skin appears nodular protuberance the size of rice grain, without any discomfort, and there may be no new blood vessels around the nodule. Further development, local ulceration, the formation of erosive ulcers, edge uplift, hard around. Generally, the progress is slow, the course of disease often reaches several years to decades, and distant metastasis rarely occurs. (3) Squamous cell carcinoma of eyelid? Tumors often invade the upper eyelid, with inflammation or scar damage, similar to basal cell carcinoma, but with obvious keratinization, often forming ulcers quickly, proliferating on the surface, progressing rapidly, often appearing distant metastasis several months after the onset, and the malignant degree is higher than that of basal cell carcinoma. (4) Meibomian adenocarcinoma? Originated from meibomian gland, the upper eyelid is common and has different shapes. At the early stage, it looks like chalazion, with yellow appearance and irregular petal shape, but its texture is hard and its progress is slow. It can invade eyelid margin and conjunctiva, and it can also metastasize to deep orbit and submandibular lymph nodes. This disease mostly occurs in the elderly. If the elderly find hard chalazion, they should go to the hospital for examination and treatment in time.