Orbital Lymphangioma in an Adolescent Male: A Case Report and Review of Literature.

Lymphangiomas are localized multi-cystic malformations of the lymphatic and vascular system, primarily affecting the head and neck regions in children. Orbital lymphangiomas are not considered hamartomas because the orbit does not commonly display lymphatic vessels. In this case report, we describe a male patient who was 15 years old and presented to our medical facility with the primary complaints of having a bulging left eye, sudden chemosis of the lower conjunctiva, and pain in the left eye. During the examination of the left eye by the ophthalmologist, proptosis, hyperlacrimation, conjunctival hyperemia, keratopathy, and pain on probing were found. A magnetic resonance imaging (MRI) of both orbits was recommended, which revealed an ill-defined, multi-locular heterogeneous solid-cystic mass in the left retrobulbar space. He was subsequently admitted to the healthcare facility for a biopsy of the orbital lesion. The examination of the specimen, both at the macroscopic and microscopic levels, was consistent with the diagnosis of lymphangioma. Given the potential risk of damage to adjacent structures, the patient was initially scheduled for sclerotherapy rather than a surgical excision. A total of three sessions of bleomycin-based sclerotherapy were administered to the patient. The patient gradually improved in the follow-up period, achieving complete remission of pain, proptosis, and chemosis. However, considering the possibility of new episodes arising, it was recommended that he attend regular follow-up appointments. The purpose of this case report is to present a rare case of orbital lymphangioma and emphasize the clinical and radiological features and management of orbital lymphangiomas.