Cavernous intraconal orbital hemangioma infiltrating the inferior oblique muscle managed surgically: A case report

Abstract

Abstract Orbital cavernous hemangioma is the most common benign vascular tumor of the orbit. They are gradually developing, painless tumors causing most frequently axial proptosis. It comprises a compact, tough, fibrous capsule covering a thrombosed, and septate venous convolution. The two main imaging techniques advised are magnetic resonance imaging (MRI) and computed tomography (CT), with the preference for MRI as it minimizes radiation exposure. We report a case of a 21-year-old female presented with protrusion of the left eye for 1 year. Examination revealed 6/6 vision in both eyes on Snellen’s chart. Color vision, contrast sensitivity, and visual fields were normal. The patient exhibited axial proptosis. On contrast-enhanced CT of orbit and contrast-enhanced MRI of the brain and orbit, she was found to have mass in the retrobulbar intraconal region. Surgical excision is the treatment of choice in symptomatic patients. A multidisciplinary team, including the ophthalmology and neurosurgery departments, performed the surgery. With careful dissection complete excision of the lesion was done. The postoperative vision was 6/6 in both eyes. Lid edema, ptosis, and limitation of extraocular movements were resolved in subsequent follow-ups. There was resolution of the proptosis with a good visual outcome. This report emphasizes the need for prompt surgical intervention with complete removal of the tumor to prevent recurrence and bleeding.