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39 Cards in this Set
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Orbital Mass Lesions
Within or Involving the Globe |
Retinoblastoma
(inheritance 1/20000 4 types i) non inheritible ii)inherited as an AD trait iii) association with partial deletion of Chr 13 iv) Bilateral retinoblastoma and pineal tumor-trilateral retinoblastoma Melanoma Detachment and choroidal effusion |
Classify by site in relation to the muscle cone
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Orbital Mass Lesions
Within the muscle cone (intraconal) |
Optic Nerve Glioma
Optic Nerve Meningioma Hemangioma (usually cavernous) AVM Inflammatory orbital pseudotumor (an enhancing soft tissue mass that may involve the muscle cone or optic nerve) lymphoma and Mets hematoma Neurofibroma (rare) |
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Orbital Mass Lesions
Arising from the muscle cone |
Inflammatory orbital pseudotumor
Dysthyroid opthalmopathy rhabdomyosarcoma 50% < 7 yo 10% arise in the orbit *diffeerntiate between primary orbital location and parameningeal loaction as therapy differs |
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Orbital Mass Lesions
Outside the muscle cone (extraconal) |
orbital cellulitis and abscess
lymphoma and mets dermoid and teratoma (most common lateral aspect) lymphangioma, lymphohemangioma spread from lacrimal gland tumor |
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Orbital Mass Lesions
Arising from the Orbital wall |
Mets lymphoma
Langerhans Cell Histiocytosis Invasion by ethmoidal or maxillary antral tumors ethmoidal mucocele Spread of ethmoidal or antral infection |
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Enlarged Orbit
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Neurofibromatosis
Congenital glaucoma (buphthalmos assymetrical enlargement) Any space occupying lesion |
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Bare Orbit
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Neurofibromatosis
Mets menigioma |
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Enlarged Optic Foramen
Diameter > 7mm A diffence in 1mm diameter is abnormal when comparing to the opposite side. |
Concentric Enlargement
optic nerve glioma neurofibroma extension of retinoblastoma'vascular granuloma Local Defect Roof adjacent neoplasm raised intracranial pressure Medial wall adjacent neoplasm sphenoid mucocele Inferolateral wall (see superior orbital fissure) |
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Enlarged Superior Orbital Fissure
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normal variant
neurofibromatosis extension of itracranial lesion (meningioma, infraclinoid aneurysm, parasellar chordoma) Mets to wing of Sphenoid Extension of Orbital lesion (AVM, hemangioma, orbital memingioma, lymphoma) |
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Intraorbital calcification
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In the Globe
cataract retinoblastoma old trauma / infection Outside the Globe phleboliths (AVN, hemangioma) Orbital memningioma Others (neurofibroma, intraorbital dermoid, adenocarcinoma of the lacrimal gland) |
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HyperOstosis in the Orbit
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Meningioma
Sclerotic Mets Fibrous Dysplasia Paget's disease Osteopetrosis Chronic osteomyelitis Lacrimal gland malignancy LCH Rx |
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Small or Absent Sinuses
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Congenital
Congenital abscence Cretinism Down's Kartageners Outgrowth of Bony wall Paget's Dx Fibrous Dysplasia Hemolytic Anemia Post Caldwell-Luc operation |
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Opaque Maxillary Antrun
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traumatic
fracture overlying soft tissue swelling Post-operative washout/Caldwel luc Epistaxis Barotrauma Inflammatory / Infective Infection Allergy Pyocele (infected mucocele) Neoplastic Ca Lymphoma Others FD Cysts (dentigerous and mucous retention cysts may be large enough to fill the antrum) Wegener's |
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Mass in the Maxillary Antrum
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Cysts
i) mucous retention cyst (result sinusitis more common and hard to differentiate from polyp) ii) dentigerous cyst (extends upwards into the floor of the antrum. The involved tooth may be displaced into the antrum Trauma (tear drop of prolapsed muscle) Neoplasm polyp complication of sinusitis carcinoma (bone destruction local spread) Wegener's (40-50 early mucosal thickening to a mass with bone destruction) |
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Cystic Lesions in the Jaw
Dental |
Peridontal/radicular/periapical cysts(develop in carious tooth. well defined lucency with a thin sclerotoc margin. If large may erode the inner cortex of the mandible, displace adjacent teeth and/or extend into the maxillary antrum
Dentigerous Cyst (adjacent to the crown of an unerupted tooth (usually wisdomor canine0 If large may displace adjacent teeth and extend into the maxillary antra or nose. Mutiple cysts in Gorlin Syndrome) |
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Orbital Mass Lesions
Within or Involving the Globe |
Retinoblastoma
(inheritance 1/20000 4 types i) non inheritible ii)inherited as an AD trait iii) association with partial deletion of Chr 13 iv) Bilateral retinoblastoma and pineal tumor-trilateral retinoblastoma Melanoma Detachment and choroidal effusion |
Classify by site in relation to the muscle cone
|
|
|
Orbital Mass Lesions
Within the muscle cone (intraconal) |
Optic Nerve Glioma
Optic Nerve Meningioma Hemangioma (usually cavernous) AVM Inflammatory orbital pseudotumor (an enhancing soft tissue mass that may involve the muscle cone or optic nerve) lymphoma and Mets hematoma Neurofibroma (rare) |
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Orbital Mass Lesions
Arising from the muscle cone |
Inflammatory orbital pseudotumor
Dysthyroid opthalmopathy rhabdomyosarcoma 50% < 7 yo 10% arise in the orbit *diffeerntiate between primary orbital location and parameningeal loaction as therapy differs |
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Orbital Mass Lesions
Outside the muscle cone (extraconal) |
orbital cellulitis and abscess
lymphoma and mets dermoid and teratoma (most common lateral aspect) lymphangioma, lymphohemangioma spread from lacrimal gland tumor |
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Orbital Mass Lesions
Arising from the Orbital wall |
Mets lymphoma
Langerhans Cell Histiocytosis Invasion by ethmoidal or maxillary antral tumors ethmoidal mucocele Spread of ethmoidal or antral infection |
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Enlarged Orbit
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Neurofibromatosis
Congenital glaucoma (buphthalmos assymetrical enlargement) Any space occupying lesion |
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Bare Orbit
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Neurofibromatosis
Mets menigioma |
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Enlarged Optic Foramen
Diameter > 7mm A diffence in 1mm diameter is abnormal when comparing to the opposite side. |
Concentric Enlargement
optic nerve glioma neurofibroma extension of retinoblastoma'vascular granuloma Local Defect Roof adjacent neoplasm raised intracranial pressure Medial wall adjacent neoplasm sphenoid mucocele Inferolateral wall (see superior orbital fissure) |
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Enlarged Superior Orbital Fissure
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normal variant
neurofibromatosis extension of itracranial lesion (meningioma, infraclinoid aneurysm, parasellar chordoma) Mets to wing of Sphenoid Extension of Orbital lesion (AVM, hemangioma, orbital memingioma, lymphoma) |
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Intraorbital calcification
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In the Globe
cataract retinoblastoma old trauma / infection Outside the Globe phleboliths (AVN, hemangioma) Orbital memningioma Others (neurofibroma, intraorbital dermoid, adenocarcinoma of the lacrimal gland) |
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HyperOstosis in the Orbit
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Meningioma
Sclerotic Mets Fibrous Dysplasia Paget's disease Osteopetrosis Chronic osteomyelitis Lacrimal gland malignancy LCH Rx |
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Small or Absent Sinuses
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Congenital
Congenital abscence Cretinism Down's Kartageners Outgrowth of Bony wall Paget's Dx Fibrous Dysplasia Hemolytic Anemia Post Caldwell-Luc operation |
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Opaque Maxillary Antrun
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traumatic
fracture overlying soft tissue swelling Post-operative washout/Caldwel luc Epistaxis Barotrauma Inflammatory / Infective Infection Allergy Pyocele (infected mucocele) Neoplastic Ca Lymphoma Others FD Cysts (dentigerous and mucous retention cysts may be large enough to fill the antrum) Wegener's |
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Mass in the Maxillary Antrum
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Cysts
i) mucous retention cyst (result sinusitis more common and hard to differentiate from polyp) ii) dentigerous cyst (extends upwards into the floor of the antrum. The involved tooth may be displaced into the antrum Trauma (tear drop of prolapsed muscle) Neoplasm polyp complication of sinusitis carcinoma (bone destruction local spread) Wegener's (40-50 early mucosal thickening to a mass with bone destruction) |
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Cystic Lesions in the Jaw
Dental |
Peridontal/radicular/periapical cysts(develop in carious tooth. well defined lucency with a thin sclerotoc margin. If large may erode the inner cortex of the mandible, displace adjacent teeth and/or extend into the maxillary antrum
Dentigerous Cyst (adjacent to the crown of an unerupted tooth (usually wisdomor canine0 If large may displace adjacent teeth and extend into the maxillary antra or nose. Mutiple cysts in Gorlin Syndrome) |
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Cystic Lesions in the Jaw
Non-Dental |
Developmental/fissural cysts
i) nasopalantine cyst-usually between 4-6th decade. A small asymptomatic cyst near the anterior palantine papilla ii)Globulomaxillary cyst between the lateral incisor and canine iii)Nasolabial cyst-in the soft tissue between the nose and the upper lip Hyperparathyroididm Neoplasms i)ameloblastoma 80% mandible 20% maxilla ii)LGH iii)ABC iv) GCT v)hemangioma vi)mets Fibrous Dysplasia Bone cyst |
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Floating Teeth
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Severe Peridontal disease
LCH Hyperparthyroididm Mets Myeloma |
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Loss of Lamina Dura of the teeth
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Generalized
Endocrine (osteoporosis, HPT, Cushings, Osteomalacia Paget's Dx Scleroderma Localized infection neoplasm (leukemi, Myeloma LCH) |
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Mass in the Nasopharynx
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Adenoid 1-7 years
Trauma (# of the upper cervical spine with hematoma) Infection +/- speckeled gas in the mass Neoplasms Benign angiofibroma antrochoanal polp Neoplasms Malignant(Nasopharangeal ca, lymphoma, Rhabdomyosarcoma,plasmacytoma, extension of ca sphenoid/ethmoid and chordoma) Encephalocele (midline defect in the base of the skull |
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Prevertebral Soft Tissue Mass on the Lateral Cervical X-Ray
Child |
Trauma/hematoma
Abscess Neoplasm (cystic hygroma, lymphoma, nasopharyngeal rhabdomyosarcoma, neuroblastoma |
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Mass on the Lateral Cervical X-Ray
Child |
Trauma/hematoma
Abscess Neoplasm (post cricoid ca, lymphoma, chordoma) Pharangeale pouch (+/-air fluid level) Retropharyngeal Goitre |
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Neck masses in Infants and Children
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Soft
lipoma hemangioma cystic hygroma Firm cyst (thyroglossal, branchial cleft (lateral position) lingual, thymic) abscess hematoma Inflammatory lymphadenopathy Neoplastic lymphadenopathy Neoplasia Thyroid |
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Whole Body iodine Scan for Localizings Mets
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Mets
Thyroid Bed normal thyroid tissue (ectopic, retrosternal, sublingual) Normal Uptake (GU tract, nasopharynx. saliavary gland stomach breast) |
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Photopenic 'Cold' Area in Radionuclide Thyroid Imaging
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Loaclized
colloid cyst adenoma ca multinodular goiter local thyroiditis (may also be increased uptake) Vascular hemorrhage artefacts abscesses Generalized Reduction in Uptake Medication Hypothyroidism Ectopic Hormone Production De Quervains Thyroiditis Ectopic Thyroid |
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