Orbital tumors constitute a group of diverse lesions with a low incidence in the population. Tumors affecting the eye and ocular adnexa may also secondarily invade the orbit. Lack of accumulation of a sufficient number of cases with a specific diagnosis at various orbital centers, the paucity of prospective randomized studies, animal model studies, tissue bank, and genetic studies led to the development of various myths regarding the diagnosis and treatment of orbital lesions in the past. These myths continue to influence the diagnosis and treatment of orbital lesions by orbital specialists. This manuscript discusses some of the more common myths through case summaries and a review of the literature. Detailed genotypic analysis and genetic classification will provide further insight into the pathogenesis of many orbital diseases in the future. This will enable targeted treatments even for diseases with the same histopathologic diagnosis. Phenotypic variability within the same disease will be addressed using targeted treatments.
Keywords: Adenoid Cystic Carcinoma; BRAF; Basal Cell Carcinoma; Cavernous Hemangioma; Cetuximab; Epidermal Growth Factor Receptor; Fluid-Fluid Levels; Hedgehog Pathway; Idiopathic Orbital Inflammation; MYB; Optic Glioma; Orbitotomy; Receptor Tyrosine Kinase Inhibitor; Schwannoma; Sorafenib; Squamous Cell Carcinoma; Targeted Treatment; Vismodegib.