Habbash Zainab
Radiology, Salmaniya Medical Complex, Manama, BHR.
Cureus. 2024 Oct 24;16(10):e72309. doi: 10.7759/cureus.72309. eCollection 2024 Oct.
Orbital cavernous hemangiomas are the most common benign orbital tumors in adults, typically presenting as slowly progressive, painless proptosis. These lesions can lead to cosmetic concerns, optic nerve compression, and, in severe cases, visual impairment. Timely diagnosis and appropriate management are crucial. This case report presents the diagnostic approach, management, and follow-up of a patient with a slow-flow orbital cavernous hemangioma, adhering to conservative management principles. A 37-year-old woman presented with a six-month history of progressive left eye proptosis without visual disturbances or pain. Physical examination revealed non-pulsatile proptosis with normal visual acuity and no optic nerve involvement. Laboratory investigations, including thyroid function tests, were unremarkable. Orbital ultrasonography revealed a well-defined hypoechoic mass and subsequent magnetic resonance imaging confirmed a 2.5 cm, lobulated, hyperintense lesion in the left orbit, consistent with an orbital cavernous hemangioma. The lesion was extraconal, displacing but not compressing the optic nerve. A diagnosis of a slow-flow orbital cavernous hemangioma was made. Orbital cavernous hemangiomas can be effectively managed conservatively in cases with minimal symptoms and no visual impairment. Regular follow-up is essential to monitor for progression, and surgical intervention should be reserved for cases with significant proptosis or optic nerve compression.
眼眶海绵状血管瘤是成人最常见的眼眶良性肿瘤，通常表现为缓慢进展的无痛性眼球突出。这些病变可导致美容问题、视神经受压，严重时可导致视力损害。及时诊断和适当处理至关重要。本病例报告介绍了一名患有缓慢血流眼眶海绵状血管瘤患者的诊断方法、处理及随访情况，遵循保守治疗原则。一名37岁女性，有6个月进行性左眼突出病史，无视力障碍或疼痛。体格检查发现非搏动性眼球突出，视力正常，无视神经受累。实验室检查，包括甲状腺功能检查，均无异常。眼眶超声显示边界清晰的低回声肿块，随后磁共振成像证实左眼眶有一个2.5 cm的分叶状高信号病变，符合眼眶海绵状血管瘤。病变位于肌锥外，推移但未压迫视神经。诊断为缓慢血流眼眶海绵状血管瘤。对于症状轻微且无视力损害的眼眶海绵状血管瘤病例，可采用保守治疗有效处理。定期随访对于监测病情进展至关重要，对于有明显眼球突出或视神经受压的病例应保留手术干预。
