Cavernous hemangioma: a term to be canceled

Abstract

Many Authors still refer to “cavernous hemangioma”.\ud \ud To be correct, the term should indicate a tumor. Are cavernous hemangioma tumors? No. In a recent research Rootman et al. have demonstrated that CHs are non-infiltrating, focal venous malformations. They lack hyperplasia, that is, the cell turnover rate is not altered and they grow (when they do it, by an average 10 % per year) owing to phenomena of localized intravascular coagulation (LIC) and subsequent inflammation. Just like other Puig Type I venous malformations, they are (almost) excluded from the general circulation.\ud \ud Since isolated venous malformations of the orbit are not tumors, indications for surgery and, especially, the related informed consent must take this into consideration. Only those malformations presenting clear symptoms, like reduction in visual acuity and/or diplopia should be managed surgically. Another, less agreed on, indication is morphologically significant exophthalmos. Small, asymptomatic malformations, especially those located intraconally, can be just observed over time. Nonsurgical measures such as low molecular weight heparin could be used to stem episodes of LIC.\ud \ud Thus we believe that the term “cavernous hemangioma” should be canceled and replaced by Venous Malformation of the Orbit

Risks and Benefits of Surgical Excision of Orbital Cavernous Venous Malformations (So-Called Cavernous Hemangioma): Factors Influencing the Outcome

“…However, wide discrepancy is reported in literature on possible postoperative visual deterioration caused by the excision itself, which may vary from 2% to 32%. 1–21 In addition, the course and the management of asymptomatic orbital hemangioma have been controversially discussed, 9,10,15 and no statistical validation of the risk/benefit ratio for surgical removal of OCMV has been reported in literature. The present study based on a large cohort of patients collected in a tertiary referral center was designed to assess the benefits and the complications related to the surgical excision of the OCMVs, also aiming to evaluate possible factors influencing the outcome.…”

About venous malformations of the facial bones

“…We believe that they have made the point in underlining how, despite an effortless work of ISSVA, there is still confusion, misdiagnosis, and thus improper treatment of many cases. In particular, venous malformations (VMs) continue to be oftentimes named Bhemangiomas^or Bcavernous hemangiomas.^We totally agree on this as we have previously published [1]. Fàbiàn et al reveal how frequently this mistake is still perpetrated, and this is the first reason why the authors should be congratulated.…”

Orbital pseudotumor as a result of chronic sinusitis in an HIV‐positive patient

“…The differential also includes Tolosa–Hunt syndrome (a related condition with involvement of the cranial nerves in the cavernous sinus and resulting ophthalmoplegia), thyroid‐associated orbitopathy, orbital sarcoidosis, orbital metastases, orbital cellulitis, and orbital venous malformation. Colletti and Deganello reviewed venous malformations of the orbit, formerly known as cavernous hemangiomas, which are the most common vascular lesion of the orbit in adults. They noted that newer nomenclature for classification of vascular anomalies recommends discontinuing the use of the older, historical term cavernous hemangiomas, and referring to these slow flow vascular lesions as orbital venous malformations.…”