The role of ultrasound-guided tissue sampling techniques in the management of extra-ocular orbital lesions

Abstract

Background

Multiple disease processes may arise within the orbit and imaging plays a vital role in the evaluation of such lesions. The anterior orbital contents are readily amenable to evaluation by ultrasonography. Furthermore, the modality can be used to guide tissue sampling (fine needle aspiration or core biopsy) and may obviate the requirement for invasive surgical biopsy.

Methods

We carried out a retrospective review of ultrasound-guided fine needle aspirations/core biopsies of extra-ocular orbital lesions undertaken at our institution. The anatomical locations, sonographic appearances and sampling techniques were analysed.

Results

There were 7 fine needle aspirations and 1 core biopsy carried out during the period analysed. Multimodality imaging was available in all cases. The majority of lesions were located in the region of the lacrimal gland. All procedures were well-tolerated and there were no post-procedure complications.

Conclusion

Many extra-ocular, orbital neoplasms are amenable to ultrasound-guided tissue sampling and the procedure is well tolerated. However, a clear understanding of orbital anatomy, differential diagnosis and technique is required to enable safe sampling. Furthermore, a collaborative, multimodality approach is imperative for optimal patient management.

Keywords

Head and neck diagnostic ultrasound

Get full access to this article

View all access options for this article.

References

Holland

Maune

Kovács

et al.

Metastatic tumors of the orbit: A retrospective study. Orbit 2003; 22: 15–24.

Bonavolontà

Strianese

Grassi

et al.

An analysis of 2,480 space-occupying lesions of the orbit from 1976 to 2011. Ophthal Plast Reconstr Surg 2013; 29: 79–86.

Shields

Scartozzi

. Survey of 1264 patients with orbital tumors and simulating lesions: The 2002 Montgomery Lecture, part 1. Ophthalmology 2004; 111: 997–1008.

Dutton

Orbital diseases. In: Yanoff

Duker

(eds). Ophthalmology, 4th ed. London: Elsevier, 2014, pp. 1318–1332.

Valenzuela

Archibald

Fleming

et al.

Orbital metastasis: Clinical features, management and outcome. Orbit 2009; 28: 153–159.

Yarovoy

Bulgakova

Shatskikh

et al.

CORE needle biopsy of orbital tumors. Graefes Arch Clin Exp Ophthalmol 2013; 251: 2057–2061.

Bourne

Karcioglu

Orbital biopsy. In: Karcioglu

(ed). Orbital tumors: Diagnosis and treatment, New York: Springer, 2015, 2015, pp. 121–128.

Liu

. Complications of fine needle aspiration biopsy. Ophthalmology 1985; 92: 1768–1771.

Dey

Radhika

Rajwanshi

et al.

Fine needle aspiration biopsy of orbital and eyelid lesions. Acta Cytol 1993; 37: 903–907.

10.

Tijl

Koornneef

. Fine needle aspiration biopsy in orbital tumours. Br J Ophthalmol 1991; 75: 491–492.

11.

Kennerdell

Dekker

Johnson

et al.

Fine needle aspiration biopsy use in orbital tumour. Arch Ophthalmol 1979; 97: 1315–1317.

12.

Gupta

Sood

Gulati

et al.

Orbital mass lesions: US-guided fine-needle aspiration biopsy-experience in 37 patients. Radiology 1999; 213: 568–572.

13.

Orlandi

Sconfienza

Lacelli

et al.

Ultrasound-guided core-needle biopsy of extra-ocular orbital lesions. Eur Radiol 2013; 23: 1919–1924.

14.

Pagni

Jaconi

Smith

et al.

The role of fine needle aspiration of orbital lesions: A case series. Acta Cytol 2016; 60: 31–38.

15.

Lagrèze

Rössler

Illerhaus

et al.

Therapy of tumors of the anterior orbit. Ophthalmologe 2011; 108: 519–530.

16.

Dubois

. Computed tomographic localisation for fine needle aspiration biopsy of orbital tumours. Radiology 1979; 13: 149–152.

17.

Czerniak

Woyke

Daniel

et al.

Diagnosis of orbital tumours by aspiration biopsy guided by computerised tomography. Cancer 1984; 54: 2385–2389.

18.

Ramzy

Herbert

Cytopathology: The history, the present and the future direction. In: Gray

Kocjan

(eds). Diagnostic cytopathology, 3rd ed. London: Churchill Livingstone, 2010, 2010, pp. 3–13.

19.

Kraft

Laeng

Schmuziger

et al.

Comparison of ultrasound-guided core-needle biopsy and fine needle aspiration in the assessment of head and neck lesions. Head Neck 2008; 30: 1457–1463.

20.

Huang

Lin

et al.

Comparison of ultrasonographically guided fine-needle aspiration and core needle biopsy in the diagnosis of parotid masses. J Clin Ultrasound 2012; 40: 189–194.

21.

Gong

Sneige

Guo

et al.

Transthoracic fine-needle aspiration vs concurrent core needle biopsy in diagnosis of intrathoracic lesions: A retrospective comparison of diagnostic accuracy. Am J Clin Pathol 2006; 125: 438–444.

22.

Leifland

Lundquist

Lagerstedt

et al.

Comparison of preoperative simultaneous stereotactic fine needle aspiration biopsy and stereotactic core needle biopsy in ductal carcinoma in situ of the breast. Acta Radiol 2003; 44: 213–217.

23.

Tani

Seregard

Rupp

et al.

Fineneedle aspiration cytology and immunocytochemistry of orbital masses. Diagn Cytopathol 2006; 34: 1–5.

24.

Kennerdell

Dubois

Dekker

et al.

CT guided fine needle aspiration biopsy of orbital optic nerve tumours. Ophthalmology 1980; 87: 491–496.