Fine Needle Aspiration of the Orbit and Ocular Adnexa. A Retrospective Study of 59 Cases

     Background: Primary and metastatic tumor diseases are rare in the orbit and ocular adnexa. Fine needle aspiration cytology (FNA) is a simple procedure and provides a valuable preoperative assessment with high diagnostic accuracy. This study addresses our experience in the diagnosis of such lesions.

     Design: A total of 59 FNAs were performed on lesions of the orbit and ocular region, between 1999 and 2004 (orbit n=45; ocular adnexa n=14). Cytology, histo­pa­thology and medical records were reviewed. Cytological diagnoses were correlated with histopathology and clinical follow-up in order to evaluate the utility of FNA in the management of these patients. FNA was done in 20 cases for primary diagnosis, and on follow-up of known diseases for the remaining 39.

     Results: Patients ranged in age from 1 to 86 years old (mean age: 51,1 yrs). The male/female ratio was nearly equal (30/29). Among the 59 FNAs, 37 (63%) were diagnosed as malignant and  9 (15%) as non neoplastic lesions. In 13 cases (22%) the sample was considered inadequate for diagnosis. Malignant diagnoses included the following entities: skin adnexal tumor, squamous cell carcinoma, metastatic carci­noma, malignant melanoma, sarcoma and lymphoma. There were no false positive results. There were 2 false negative results (3,4%). No complications were reported.

     Conclusions: FNA is a reliable, safe and minimally invasive diagnostic technique that can be routinely used in outpatient clinics for a rapid diagnosis, allowing distin­guishing between inflammatory, benign and malignant lesions and the subtypes of malignant tumors of the orbit and ocular adnexa.