title: The pattern of lymphatic metastasis of malignant tumors in the periorbital area.
abstract: OBJECTIVE
  The rarity of malignant tumors in the periorbital area makes it difficult to assess the patterns of lymphatic spread and to determine the optimal extent of treatment. The objective of this study was to analyze the patterns of lymphatic metastasis in malignant tumors arising from the periorbital area according to the primary site and to assess the optimal extent of surgical treatment for these tumors.
  
  
  METHODS
  We retrospectively reviewed the medical records of 8 patients with malignant tumors in the periorbital area from January 1997 to June 2002. The mean duration of follow-up was 27.5 months. Five primary tumors were located in the medial half of the periorbital area, 2 tumors in both medial and lateral halves, and 1 tumor in the lateral half. The pathological diagnoses were 3 squamous cell carcinomas, 2 adenoid cystic carcinomas, 2 sebaceous carcinomas, and 1 basal cell carcinoma.
  
  
  RESULTS
  The lymphatic metastasis was observed in 4 of 8 patients who had a relatively large (> or =4 cm) primary tumor or poorly differentiated tumor. Four of 7 tumors involving the medial half of the periorbital area exhibited lymphatic spread to the periparotid lymph node and level II cervical lymph node groups.
  
  
  CONCLUSIONS
  The results of this study suggest that more aggressive management of the parotid area is necessary in malignant tumors arising from the periorbital area, even in the medial half of the periorbital area.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Han-Sin
authors.initials: HS
authors.lastname: Jeong
authors.forename: Young-Ik
authors.initials: YI
authors.lastname: Son
authors.forename: Chung-Hwan
authors.initials: CH
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology* / Q000556:secondary* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007723:Korea; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009918:Orbital Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate