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


RR Fonseca, J Cabral, E Mendonça

     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.


no 94th Annual Meeting of Modern Pathology em San Antonio, Texas, USA, Março de 2005