Multiple cavernous hemangiomas in the orbit

Abstract

Rational: Cavernous hemangiomas are one of the most common benign primary orbital lesions. These tumors are insidious in onset, slowly progressive and present more often in middle aged women. Multiple orbital cavernous hemangiomas are extremely rare, and only a few cases have been reported in the published literature. Patient concerns: Here, we report the diagnosis and treatment of multiple cavernous hemangiomas in the right orbit of a female patient with impaired visual acuity and proptosis of the eye for more than 10 years. Diagnosis: Magnetic resonance imaging of the orbit showed a giant and irregular soft mass filling the intraconal and extraconal space of the right orbit, compressing the right optic nerve. After tumor resection, histopathological examination confirmed the diagnosis of cavernous hemangioma. Interventions: A lateral orbitotomy was performed and a total of 13 tumors were excised, with the largest tumor measuring approximately 2.5 × 3.0 cm. Outcomes: The visual acuity of the patient was preserved, with only a slightly dilated pupil of the right eye. The follow-up period was 6 months with no signs of recurrence. Lessons: Multiple cavernous hemangiomas in the orbit is rare and should be excised surgically as soon as possible.

Presenting Characteristics for Symptomatic, as Compared to Asymptomatic (assumed), Orbital Cavernous Venous Malformations

“…70%. 11 Multiple OCVMs lesions have been reported in several series, 4,12 but only 3 patients from a historic Moorfields series 4 were identifiable in this retrospective review. Paradoxically, there have been no cases of bilateral or multiple OCVMs identified since 1990, which possibly reflects, in recent decades, the earlier presentation of patients and the markedly increased use of imaging for other conditions.…”

Case report of cavernous haemangioma in the supraorbital region in the extraconal space: A rare location

“…Angiography is rarely required. 6 The tumours are round to oval in shape with well-defined borders and a specific ‘honeycomb’ pattern of alternating weak and strong echoes corresponding to their structure, with flow demonstrated with colour Doppler interrogation although they may also demonstrate a negative Doppler phenomenon, which is attributable to the stagnant blood within the vascular spaces. 7 CT scan shows discrete lesions with varying degrees of enhancement.…”

Orbital hemangioma extirpation via a transnasal endoscopic surgical approach: A case report

“…In a large case series, tumor recurrence was not reported when lesions were removed entirely. However, recurrence may occur when tumors are incompletely removed [19] . Yan and Wu [20] reported three incidences of recurrence in nine incompletely removed patients.…”

“…The basic fibroblast growth factor (bFGF) is expressed by orbital cavernous hemangiomas and can promote the development of vascular smooth muscle and endothelial cells, which may contribute to tumor progression. Even after the tumor has been completely excised, the produced and remaining bFGF may retain the ability to promote cavernous hemangioma development [19] .…”