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Purpose

To analyze the clinical, radiologic, and pathologic features of orbital fungating masses and to identify prognostic factors.

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Methods

A retrospective analysis of the Orbital fungating masses is presented by utilizing the hospital records from 2017 to 2025. The population was divided into two groups for analysis: children, ≤18 years, and adults, >18 years. Demographic, clinical, radiologic, and pathological features were studied.

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Results

Of 3,047 orbital tumors, 24 (0.79%) presented as fungating orbital masses. The median age was 36.5 years (range 1–73), with 62.5% females and 66.7% from rural backgrounds. One-fourth had received prior treatment from unqualified practitioners. The mean symptom duration was 62.6 months, and all patients presented with progressive swelling; 58.3% showed severe or profound visual loss. Radiologically, isolated orbital and adjacent bony involvement were most frequent, each seen in 33.3%. Adjacent bony invasion showed a statistically significant correlation with bony destruction (p=0.008), whereas intracranial extension occurred in 12.5%, which consistently showed globe deformity and optic nerve invasion. Overall, 62.5% of lesions were malignant, more frequent in adults above 18 years as compared with children (75.0% vs 37.5%; p=0.099). The commonest malignancy in children was retinoblastoma, and the commonest benign lesion was vascular–lymphatic malformation, while in adults, the commonest malignancy was sebaceous gland carcinoma. Overall, the mortality rate was 25% in children and 18.8% in adults (p=0.66), all with lymph node metastasis and systemic weight loss (p<0.001).

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Conclusion

This study represents the largest single-institution series of orbital fungating masses reported to date. We seek to describe their clinical, radiologic, and pathologic profiles, while highlighting corelation and prognostic indicators that influenced outcomes.Fungating orbital masses are rare but often malignant in adults with high morbidity and poor visual outcomes. Advanced radiologic extension, nodal metastasis, and systemic weight loss were strong predictors of poor prognosis. Public health measures, emphasizing early diagnosis and educating on the need for seeking care from qualified practitioners, remain an important part of any strategy to improve outcomes.

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Additional Authors

First name	Last name	Base Hospital / Institution
ankita	aishwarya	sanjay gandhi post graduate institute of medical sciences

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