Chemotherapy for childhood orbital tumors

Orbital tumors in the pediatric population are a rare event. The differential diagnosis for these tumors is broad, but only a small number of these lesions are malignant. In this chapter the chemotherapy used for the treatment of the following conditions will be discussed: (1) primary malignant orbital tumors such as rhabdomyosarcoma, lymphoma, and myeloid sarcoma; (2) malignancies that may metastasize to the orbit including neuroblastoma, Ewing sarcoma, and Wilms tumor; (3) malignancies that can invade the orbit such as retinoblastoma, optic nerve glioma, and esthesioneuroblastoma; and (4) nonmalignant processes including hemangiomas and Langerhans cell histiocytosis. A multidisciplinary team approach is essential to the treatment of these tumors in order to provide children with the best and most appropriate care possible. The treatments for these tumors are constantly evolving, and given the rarity of most of these conditions, understanding and improvement in outcomes will come about only with a cooperative, multidisciplinary approach within the context of large group trials.