Abstract / Summary
Background: Orbital squamous cell carcinoma (SCC) is a rare entity. It is a locally invasive malignancy which spreads to orbital structures, and if left untreated, can spread intracranially. The definitive treatment for SCC which is confined to the orbit is orbital exenteration. The aim of this study was to describe the radiological features of orbital SCC in patients who underwent orbital exenteration at a tertiary eye hospital in South Africa. Methods: A retrospective cross-sectional study of 51 patients with histologically confirmed advanced orbital SCC, who underwent orbital exenteration between 01 January 2018 and 31 December 2023, analysing the radiological characteristics on computed tomography scans taken prior to exenteration. Results: The mean age was 46.7 years (s.d. 13.6), and 63% patients were male. The population was mostly African (88%), with a significant proportion (82%) testing positive for Human Immunodeficiency Virus (HIV). Majority of tumours were confined to the orbit (57%) with even laterality. Globe involvement was extensive (90%), with lacrimal gland involvement in 41% of patients. Muscle involvement was also observed with the inferior rectus muscle most affected (58%), followed by the medial rectus muscle (48%). Patients with disease confined to the orbit were less likely to have lymph node involvement (p = 0.001) and distant metastatic spread (p = 0.001). In contrast, optic nerve spread groups showed more aggressive features, with significant differences observed in lymph node involvement (p = 0.001), bone erosion (p = 0.005) and overall sinus involvement (p = 0.001). Conclusion: Squamous cell carcinoma requiring exenteration is varied in its presentation.
Contribution: Majority of patients were HIV positive. Optic nerve spread of the tumour had significantly more aggressive features.