Differential diagnosis and pathogenesis for orbital tumors

This is a review paper on the differential diagnosis and neurosurgical strategy for intraorbital lesions. A wide variety of processes produce intraorbital space-occupying lesions within the orbital cavity. These include vascular lesions, congenital lesions, inflammatory diseases, lymphoproliferative diseases, and benign and malignant neoplasms. Surgical strategy depends on each pathology, and total removal is the best treatment for non-lymphocytic tumors. To perform less invasive yet aggressive removal, neurosurgeons should be aware of the advantages and disadvantages of the various surgical approaches including the transorbital, lateral, transcranial approaches, and the rapidly developing endoscopic approaches. In some cases with involvement to important paraorbital structures, collaboration with ENT and/or plastic surgeons is required. In this paper, several representative cases among 111 cases with various intraorbital pathologies are illustrated, and the key radiological and surgical points are provided to help readers better understand the best treatment for intraorbital lesions.