Fine-needle aspiration biopsy in orbital lesions: A retrospective study of 225 cases

Abstract Purpose To describe and analyze results from the fine-needle aspiration biopsy (FNAB) technique, used as a diagnostic tool, in patients with orbital lesions. Design Retrospective case series. Methods Setting : Institutional (Karolinska Hospital, Stockholm) Study Population : 207 patients with 210 orbital lesions Intervention : 225 FNABs of the orbit Main Outcome Measures : Successful diagnosis from FNAB. Results Of the 210 orbital lesions evaluated with FNAB, a successful cytological diagnosis was achieved in 176 (84%). In more than half of the orbital lesions (54%), the FNAB-diagnosis in addition to imaging appearance, clinical appearance, and clinical history provided sufficient information for treatment, and the patient did not require an incisional or excisional biopsy. 97 patients underwent additional excisional or incisional biopsy; FNAB diagnoses and the histopathological diagnoses corresponded in 87% of the cases with an intra-class correlation coefficient of 0.84 (95% confidence interval [CI] 0.76-0.90). The difference was a statistically significant between the ability to make a successful cytological FNAB diagnosis in palpable lesions versus non-palpable lesions (successful diagnosis in 90% [CI=85-95%] versus 75% [CI=66-84%]; p0.7). There was a complication in 6 (3%) cases. All complications were temporary and none led to permanent damage. Conclusions FNAB proved effective and exceedingly safe. With the current healthcare climate of minimally invasive surgery and cost-control, FNAB should be considered as a valid alternative to open surgery in the evaluation and management of orbital lesions.