Orbital mass lesions: US-guided fine-needle aspiration biopsy - Experience in 37 patients

PURPOSE: To evaluate the safety and effectiveness of using ultrasonographic (US) guidance for performing fine-needle aspiration biopsies of orbital mass lesions. MATERIALS AND METHODS: Thirty-seven patients with mass lesions in the orbit underwent US-guided fine-needle aspiration biopsy. Computed tomographic scans were available in all patients. In 19 patients, the lesions were located in the posterior orbit, whereas in 18 patients the lesions were located in (n = 3) or extended up to (n = 15) the anterior compartment. Fine-needle aspiration biopsy was performed with 22-25-gauge needles and use of the freehand technique. RESULTS: Needle biopsies were performed safely and easily, and real-time US monitoring of the needle position was used to avoid injury to the eyeball. No major complications were encountered. Diagnostic specimens were obtained in 29 (78%) of the 37 patients, and 19 benign and 10 malignant disease processes were diagnosed. In eight patients (22%), an appropriate diagnosis could not be made, as aspiration samples yielded insufficient tissue. CONCLUSION: US provides safe and effective guidance for performing fine-needle aspiration biopsy in orbital mass lesions and is especially useful in deep-seated nonpalpable retrobulbar lesions.