Successful ECT in a patient with an orbital cavernous hemangioma

There are no cases in the literature describing the use of electroconvulsive therapy (ECT) in a patient with an intraorbital vascular mass. We report the clinical course of a 69-year-old female with a cavernous hemangioma of the left orbit who was successfully treated with ECT for major depressive disorder. There were no apparent effects on the orbital hemangioma as a result of ECT-related blood pressure elevations measured up to 195/90 mm Hg despite pretreatment with intravenous esmolol. Modulation of ECT-related cardiovascular changes in the presence of intracranial or intraorbital vascular masses remains advisable to reduce the risk of an adverse vascular event during ECT. The use of propofol anesthesia appears to be preferable in such cases.