Oral and Craniomaxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany
Department of Neuroradiology, Eppendorf University Hospital, University of Hamburg, Hamburg, Germany.
Anticancer Res. 2020 Jun;40(6):3333-3343. doi: 10.21873/anticanres.14316.
BACKGROUND/AIM: Intraosseous orbital hemangiomas or vascular malformations (VM) are rare. This report is intended to complement the experience of diagnosing and treating a rare vascular lesion at this site. Special attention is paid to three-dimensional imaging and the morphological distinction between the two entities in this location.
A 54-year-old female was examined and surgically treated for an exophytic firm mass of the infraorbital, which had become palpable as a hard mass due to growth in size. At first, a bone tumor, for example, an osteoma, was suspected. Intraoperatively, an osseous expansion with distinct fenestrations of the newly grown bone's surface, was detected. The lesion was firmly attaching to the orbital rim. The densely vascularized tumor was well defined to the soft tissues but had grown in continuity from the orbital floor and rim. Vascularized cavities caused the tumor to have a slightly reddish color. The histological examination confirmed the suspicion of the lesion's vascular origin. The lesion's immunohistochemical expression profile approved the final diagnosis of intraosseous VM.
The symptoms of intraosseous vascular lesions of the orbit are determined by location and size. Modern imaging techniques facilitate the estimation of tumor-like expansion of lesions. However, the imaging characteristics of intraosseous vascular lesions are very variable. The symptoms of the patient presented herein show that growth phases of a vascular orbital malformation can occur in later stages of life and are initially indistinguishable from a neoplasm. In individual cases, patient care necessitates advanced diagnostic measures to establish the diagnosis and determine surgical therapy.
背景/目的：骨内眼眶血管瘤或血管畸形（VM）较为罕见。本报告旨在补充在该部位诊断和治疗罕见血管病变的经验。特别注意三维成像以及该部位两种实体之间的形态学区别。
一名 54 岁女性因眶下外生坚实肿块接受检查和手术治疗，由于肿块增大，该肿块摸起来呈硬性肿块。起初，怀疑是骨肿瘤，例如骨瘤。术中发现新骨表面有明显的骨膨胀和开窗。病变与眶缘紧密相连。血管丰富的肿瘤与软组织界限分明，但从眶底和眶缘连续生长。血管化腔使肿瘤呈微红。组织学检查证实了对病变血管起源的怀疑。病变的免疫组织化学表达谱证实了骨内 VM 的最终诊断。
骨内眼眶血管病变的症状取决于位置和大小。现代成像技术有助于估计肿瘤样病变的扩张。然而，骨内血管病变的影像学特征非常多变。本文患者的症状表明，血管性眼眶畸形的生长阶段可能发生在生命的后期，并且在初始阶段与肿瘤无法区分。在个别情况下，患者护理需要先进的诊断措施来确立诊断并确定手术治疗。
