Selva D, Strianese D, Bonavolonta G, Rootman J
Department of Ophthalmology, University of British Columbia, 2550 Willow Street, Vancouver, BC, Canada V5Z 3N9.
Am J Ophthalmol. 2001 Mar;131(3):364-70. doi: 10.1016/s0002-9394(00)00826-6.
To illustrate that orbital venous-lymphatic malformations (lymphangiomas) may rarely simulate cavernous hemangiomas.
Retrospective case review.
Five patients were identified from a series of 85 patients with venous-lymphatic malformations. The age range was 21 to 69 years, and all cases presented with a history of slowly progressive or long-standing proptosis. Computerized tomography revealed relatively homogeneous intraconal masses that were well defined anteriorly. Two of the cases had expansion of the orbit, and one had focal calcification. The three who had magnetic resonance imaging showed heterogeneous contrast enhancement. The preoperative diagnosis in every case was cavernous hemangioma, and intraoperatively the lesions resembled cavernous hemangiomas. However, posterior dissection was difficult in all patients because of dense adhesions and, in one case, led to a central retinal artery occlusion. The histology was characteristic of orbital venous-lymphatic malformations in all five cases.
Deep orbital venous-lymphatic malformations presenting in adulthood may be rarely confused with cavernous hemangiomas. In doubtful cases, significant intralesional heterogeneity, best seen on magnetic resonance imaging, and focal calcification may help distinguish the two entities. This differentiation is important, because dissection of venous-lymphatic malformations is fraught with more complications than surgical excision of a cavernous hemangioma.
阐明眼眶静脉 - 淋巴管畸形（淋巴管瘤）可能极少类似海绵状血管瘤。
回顾性病例分析。
在85例静脉 - 淋巴管畸形患者中识别出5例。年龄范围为21至69岁，所有病例均有缓慢进展或长期突眼病史。计算机断层扫描显示眶内相对均匀的肿块，前部边界清晰。其中2例眼眶扩大，1例有局灶性钙化。3例行磁共振成像检查的病例显示不均匀的对比增强。每例术前诊断均为海绵状血管瘤，术中病变类似海绵状血管瘤。然而，由于粘连紧密，所有患者的后部解剖均困难，1例导致视网膜中央动脉阻塞。所有5例的组织学表现均为眼眶静脉 - 淋巴管畸形的特征。
成年期出现的深部眼眶静脉 - 淋巴管畸形可能极少与海绵状血管瘤混淆。在可疑病例中，磁共振成像上显示的明显瘤内异质性以及局灶性钙化可能有助于区分这两种病变。这种区分很重要，因为静脉 - 淋巴管畸形的解剖比海绵状血管瘤的手术切除更容易出现更多并发症。
