Rapid development of amputation neuroma following excision of an orbital cavernous hemangioma

A 48-year-old man with left proptosis and signs of optic nerve compression underwent medial transconjunctival orbitotomy for an excisional biopsy of a posteromedial orbital cavernous hemangioma. The left eye once again became proptotic and painful only 5 weeks later because of a more anteriorly growing orbital mass, which was homogeneously hyperintense relative to orbital fat on both T1- and T2-weighted MRI studies. The tumor proved to be an amputation neuroma after total excision. The latter tumor is presumed to originate most probably from the transected branch of the oculomotor nerve innervating the medial rectus muscle, which remained paralytic after the first operation.