Differential diagnosis of pediatric orbital masses

• Dacryoadenitis
• Dacrocystocoele
• Dermoid
• Encephalocoele
• Hemangioma
• Langerhans cell histiocytosis
• Leukemia (chloroma)
• Lymphatic malformation
• Lymphoma – Hodgkin and Non-Hodgkin
• Neuroblastoma metastasis
• Neurofibroma
• Optic pathway glioma
• Orbital cellulitis and subperiosteal abscess
• Retinoblastoma
• Rhabdomyosarcoma

Approach to the differential diagnosis of orbital masses:

Orbital mass by location:

	Lateral Orbit	Medial Orbit
Superior Orbit	Dermoid	Encephalocele, Rhabdomyosarcoma
Inferior Orbit	Langerhans cell histiocytosis, Neuroblastoma	Dacrocystocele

Note: Lymphatic malformation can be in any location

Orbital mass by enhancement:

	Positive contrast enhancement	No contrast enhancement
Increased T2 signal intensity	Hemangioma	Intracranial arteriovenous malformation
Very increased T2 signal intensity	Venous malformation	Lymphatic malformation