Unusual presentation of an orbital cavernous hemangioma

An orbital cavernous hemangioma is composed of large, ectatic, endothelium-lined, blood-filled spaces. Inflammatory cells, such as lymphocytes, are rarely found in the interstitium. In this case report, a Chinese woman with an unusual presentation of an orbital cavernous hemangioma resulting from a substantial infiltration of inflammatory cells is presented.

Data (unusual findings of clinical features, computed tomography, and ultrasonography examination) from a patient with an orbital cavernous hemangioma showing an obvious infiltration of inflammatory cells in the interstitium are presented.

A 45-year-old Chinese woman presented with a painless slow-growing orbital tumor in the left eye that was present for 9 years. There was a smooth, well-defined, moderate-density, tenderless mass measuring 2.5 × 3.0 cm within the medial and inferior orbit. Her left eye was superolaterally displaced. Exophthalmometry showed a 7-mm proptosis of the left eye. Computed tomography showed an ovoid orbital soft-tissue mass with a few punctate calcifications, located in the inferomedial aspect of the left orbit. Color Doppler showed a moderate blood supply within the tumor. A purplish, spongy, encapsulated 2.5 × 3.0 × 3.0 cm mass, which was moderately adherent to surrounding tissues, was completely removed by an anterior orbitotomy. No surgical complication occurred. Histopathologic examination confirmed the diagnosis of an orbital cavernous hemangioma. There was an obvious infiltration of inflammatory cells within the interstitium of the mass.

As a result of the infiltration of inflammatory cells within this case of orbital cavernous hemangioma, the atypical clinical manifestation makes it difficult to arrive at a correct presurgical diagnosis.